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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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PEARLS

This block, even in trained hands, has a variable success rate. My experience suggests that one must rely on volume for this block rather than on a “rifle-like” accuracy of needle position. Fortunately, the need to use an obturator block with the other lower extremity peripheral nerve blocks is not an absolute requirement for most surgical procedures. If this block is used diagnostically for patients with chronic pain, it is helpful to use a nerve stimulator to guide needle placement. This measure minimizes diagnostic confusion when pain relief is produced with a small volume of local anesthetic, whereas large-volume (about 15 mL) injections are performed with this block for many surgical procedures.

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