Tips for an Obturator Nerve Block: Distal Approach

The obturator nerve originates from the ventral rami of the L2 to L4 lumbar nerves. An obturator nerve block serves various purposes: providing supplemental analgesia for hip and knee surgeries, preventing thigh adduction response during transurethral bladder surgery, and relieving painful or permanent hip adductor spasticity.

Follow these 3 steps for an obturator nerve block using the distal approach

1. Place the transducer in a transverse orientation perpendicular to the inguinal crease to identify the femoral vessels. Move the transducer medially along the crease to identify the pectineus, and further medially, the adductor longus, brevis, and magnus muscles. 
2. The anterior and posterior branches of the obturator nerve can be seen running along the fascial planes superficial and deep to the adductor brevis muscle. 
3. Insert the needle in-plane or out-of-plane. Inject two aliquots of local anesthetic into the fascial planes between the adductor longus and adductor brevis muscles (anterior branch) and between the adductor brevis and adductor magnus muscles (posterior branch).

Watch the video below to get a better picture of the process and see how the NYSORA Nerve Blocks App brings these instructions to life:

For more tips like these and the complete guide to the 60 most frequently used nerve blocks, download the Nerve Blocks App HERE. Don’t miss the chance to get the bestselling NYSORA Nerve Blocks App also in book format – the perfect study companion with the Nerve Blocks app!