Hindlimb unilateral Obturator Nerve Block

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B. Braun Vet Care
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Anesthesia
Regional Anesthesia
Peripheral Nerve Block
Obturator Nerve Block

Indication

Anesthesia of the ipsilateral hindlimb distal to the mid femur. Suitable for example for knee surgery (TPLO, TTA), stifle arthroscopy and surgery of the tarsus (in combination with femoral and sciatic nerve blocks)

Step by step

Lateral position, limb to be blocked on top, limb is abducted approx. 90°, knee and tarsus are flexed approx. 90°, assistant holds knee loosely to allow for adduction muscle response to be seen
Gracilis muscle (orange), pectineal muscle (light blue)
The obturator nerve (yellow) travels caudal to the pectineal muscle (light blue) through the gracilis muscle (orange) distally
Lateral position, limb to be blocked on top, limb is abducted approx. 90°, knee and tarsus are flexed approx. 90°, assistant holds knee loosely to allow for adduction muscle response to be seen
Gracilis muscle (orange), pectineal muscle (light blue)
The obturator nerve (yellow) travels caudal to the pectineal muscle (light blue) through the gracilis muscle (orange) distally

Local anesthetics

Obturator nerve block (Nerve stimulation)

Local anesthetics: Lidocain 2%, Mepivacain 2%, Bupivacain 0.5%, Ropivacain 0.75%
Initial setting NS: 0.5-1.0 mA, 2 Hz, 0.10 ms
Needle orientation: needle insertion caudal to the insertion of the pectineal muscle in a dorsal direction, insertion angle approx. 45°
Muscle contraction: adduction of the limb
Reduction of the amperage: in small increments to <0.5 mA
Correction of the needle position: minor corrections only, pull back needle, correct angle, re-advance needle
MSC control: to avoid block failure
Aspiration and injection: slowly, Raj test, BSmart
Injection volume: 0.1 ml/kg

Videos

  • Obturator nerve block (Nerve stimulation)

    Correct muscle response (Gracilis muscle)

With the friendly assistance of
https://ktpraxis-berlin.de
Dr. Georg Papadopoulos
Veterinary Specialist for Small Animals
Additional Certification: Anesthesia in Small Animals
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Disclaimer

As with any intervention in the body, peripheral nerve blocks also carry the risk of complications. The presented procedures and dosages are thoroughly reviewed and based on currently available scientific data and clinical experience but should only be considered as guidelines along the contents of the course. The responsibility for performing the nerve blocks shown on this site as part of any anesthesia regimen or pain management lies with the executing clinician. B. Braun Vet Care GmbH and Dr. Papadopoulos cannot be held responsible for any complications or adverse effects, that may arise from the described techniques or for any mistakes in the information provided.