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KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
- Obturator nerve (ON)
- Obturator nerve block (ONB)
Definitions
- Blockade of ON
- Arises from anterior rami of L2-L4 nerve roots from lumbar plexus within psoas major muscle
- Emerges from psoas major medial into pelvis and then along obturator canal (accompanied by vessels) to reach medial thigh compartment
- ± concomitant block of additional nerves (e.g., femoral, sciatic &/or posterior lumbar plexus)
- In proximal medial thigh, it divides into anterior and posterior division and supplies adductor muscles
- Anterior division travels between adductor longus and adductor brevis muscles
- Posterior division travels between adductor brevis and adductor magnus muscles
- Responsible innervation to hip joint at inferior femoral neck, pubic ramus, medial femoral shaft, and its medial condyle
- Sensory innervation to midinner thigh and posterior knee joint
- Renders anesthesia for 6-12 hours
- Steroids can be added to anesthetic solution in cases where component of entrapment or inflammation is suspected
- Provides somatic pain coverage
- Blockade of ON
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Selected References
- Nielsen ND et al: An obturator nerve block does not alleviate postoperative pain after total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. ePub, 2019
- Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
- Bareka M et al: Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery. Knee Surg Sports Traumatol Arthrosc. 26(2):478-84, 2018
- House CV et al: CT-guided obturator nerve block via the posterior approach. Skeletal Radiol. 35(4):227-32, 2006
- Choquet O et al: A new inguinal approach for the obturator nerve block: anatomical and randomized clinical studies. Anesthesiology. 103(6):1238-45, 2005
- Heywang-Köbrunner SH et al: CT-guided obturator nerve block for diagnosis and treatment of painful conditions of the hip. Eur Radiol. 11(6):1047-53, 2001
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
- Obturator nerve (ON)
- Obturator nerve block (ONB)
Definitions
- Blockade of ON
- Arises from anterior rami of L2-L4 nerve roots from lumbar plexus within psoas major muscle
- Emerges from psoas major medial into pelvis and then along obturator canal (accompanied by vessels) to reach medial thigh compartment
- ± concomitant block of additional nerves (e.g., femoral, sciatic &/or posterior lumbar plexus)
- In proximal medial thigh, it divides into anterior and posterior division and supplies adductor muscles
- Anterior division travels between adductor longus and adductor brevis muscles
- Posterior division travels between adductor brevis and adductor magnus muscles
- Responsible innervation to hip joint at inferior femoral neck, pubic ramus, medial femoral shaft, and its medial condyle
- Sensory innervation to midinner thigh and posterior knee joint
- Renders anesthesia for 6-12 hours
- Steroids can be added to anesthetic solution in cases where component of entrapment or inflammation is suspected
- Provides somatic pain coverage
- Blockade of ON
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Selected References
- Nielsen ND et al: An obturator nerve block does not alleviate postoperative pain after total hip arthroplasty: a randomized clinical trial. Reg Anesth Pain Med. ePub, 2019
- Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
- Bareka M et al: Superior perioperative analgesia with combined femoral-obturator-sciatic nerve block in comparison with posterior lumbar plexus and sciatic nerve block for ACL reconstructive surgery. Knee Surg Sports Traumatol Arthrosc. 26(2):478-84, 2018
- House CV et al: CT-guided obturator nerve block via the posterior approach. Skeletal Radiol. 35(4):227-32, 2006
- Choquet O et al: A new inguinal approach for the obturator nerve block: anatomical and randomized clinical studies. Anesthesiology. 103(6):1238-45, 2005
- Heywang-Köbrunner SH et al: CT-guided obturator nerve block for diagnosis and treatment of painful conditions of the hip. Eur Radiol. 11(6):1047-53, 2001
