Block Performance

Preparation for the block begins with establishing a peripheral venous access and patient sedation. The patient must be supervised in a usual manner (heart rate, noninvasive blood pressure, saturation of oxygen haemoglobin). Sedation is implemented and gradually dosed until the patient is calm and comfortable. The patient is positioned in the lateral decubitus position with the side to be blocked up, tilted 30° forward and the leg to be anesthetized flexed at the knee at 90° (see figure).

The performer is approaching the patient from the back and observes the limb to be blocked for onset of muscle twitches. An assistant is useful with this block because it is very important:



     To maintain the patient in the proper position
     To reassure the patient by keeping a visual con-
       tact between patient and assistance.
     To help detect the muscular contraction of the ob-
       turator nerve stimulation.




The assistant is located in front of the patient with one hand positioned on the patient's upper thorax and the other one on the thigh to be anaesthetized.