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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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Chapter 15 – Obturator Block

PERSPECTIVE

The obturator block is most often combined with sciatic, femoral, and lateral femoral cutaneous blocks to allow surgical procedures on the lower extremities. If an operation on the knee using these blocks is planned, the obturator block is often essential. Another use for this block is in patients who have hip pain. It can be used diagnostically to help identify the cause of the pain, as block of the obturator nerve may provide considerable pain relief if the obturator’s articular branch to the hip is involved in pain transmission. Additionally, the block may be useful in the evaluation of lower extremity spasticity or chronic pain syndromes.

Patient Selection.

As with femoral and lateral femoral cutaneous nerve blocks, elicitation of paresthesias is not essential for obturator block. Hence any patient able to lie supine is a candidate.

Pharmacologic Choice.

Motor blockade is most often not necessary for surgical patients undergoing obturator nerve block; thus, lower concentrations of local anesthetics are appropriate for obturator block (i.e., 0.75%–1.0% lidocaine, 0.75%–1.0% mepivacaine, and 0.25% bupivacaine or 0.2% ropivacaine).

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