• Reg Anesth Pain Med · Jan 2012

    Randomized Controlled Trial Comparative Study

    Ultrasound-guided obturator nerve block: interfascial injection versus a neurostimulation-assisted technique.

    • Alberto Manassero, Matteo Bossolasco, Susanna Ugues, Sarah Palmisano, Umberto De Bonis, and Giuseppe Coletta.
    • Department of Anesthesiology, S. Croce e Carle Hospital, Cuneo, Italy. manassero.al@ospedale.cuneo.it
    • Reg Anesth Pain Med. 2012 Jan 1;37(1):67-71.

    Background And ObjectivesInterfascial injection of local anesthetic under ultrasound guidance has been proposed as a new technique for performing an obturator nerve block. We hypothesized that interfascial needle placement could supplant nerve stimulation as the end point for local anesthetic injection during ultrasound-guided obturator nerve block after the division of the obturator nerve.MethodsFifty spinal anesthesia patients who had experienced unilateral adductor muscle spasm during transurethral bladder tumor resection were randomly allocated to receive either 5 mL of lidocaine 2% injected under ultrasound guidance into the interfascial plane between the adductor longus and the adductor brevis and between the adductor brevis and the magnus muscles (US group) or an injection of 5 mL of lidocaine 2% in combination with nerve stimulation after identification of the divisions of the obturator nerve (USENS group). At 5, 10, and 15 minutes after block placement, muscle spasm was assessed by an independent observer masked to treatment allocation. The primary outcome was motor block onset time. Secondary outcomes were block performance time, total anesthesia-related time, motor block success at 15 minutes, and number of needle passes.ResultsMotor block onset time did not differ between the 2 groups (6.2 minutes for USENS versus 7.2 minutes for US group, P = 0.225), block performance time was longer in the USENS than in the US group (3.0 versus 1.6 minutes, P < 0.001), and total anesthesia-related time did not differ between the 2 groups (9.2 versus 8.9 minutes, P = 0.71). Block success rate at 15 minutes was 100% in the USENS group and 88% in the US group (P = 0.23). There was no difference in the number of needle passes (2.3 versus 2.1, P = 0.28).ConclusionsIn ultrasound-guided obturator nerve block performed after the division of the nerve, injection of local anesthetic between the planes of the adductor muscles is comparable to nerve stimulation.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…