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Anatomical considerations for obturator nerve block with fascia iliaca compartment block
  1. Thomas Fichtner Bendtsen1,
  2. Erik Morre Pedersen2,3,
  3. Bernhard Moriggl4,
  4. Peter Hebbard5,
  5. Jason Ivanusic6,
  6. Jens Børglum7,
  7. Thomas Dahl Nielsen1 and
  8. Philip Peng8
  1. 1Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
  3. 3Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  4. 4Institute of Clinical and Functional Anatomy, Department of Anatomy, Histology and Embryology, Medical University of Innsbruck, Innsbruck, Austria
  5. 5Department of Anesthesia Northeast Health Wangaratta, Ultrasound Education Group, University of Melbourne, Wangaratta, Victoria, Australia
  6. 6Department of Anatomy and Physiology, University of Melbourne, Melbourne, Victoria, Australia
  7. 7Department of Anesthesiology and Intensive Care, Zealand University Hospital, Roskilde, Denmark
  8. 8Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Professor Thomas Fichtner Bendtsen, Anesthesiology, Aarhus University Hospital, Aarhus DK-8200, Denmark; tfb{at}dadlnet.dk

Abstract

This report reviews the topographical and functional anatomy relevant for assessing whether or not the obturator nerve (ON) can be anesthetized using a fascia iliaca compartment (FIC) block. The ON does not cross the FIC. This means that the ON would only be blocked by an FIC block if the injectate spreads to the ON outside of the FIC. Such a phenomena would require the creation of one or more artificial passageways to the ON in the retro-psoas compartment or the retroperitoneal compartment by disrupting the normal anatomical integrity of the FI. Due to this requirement for an artificial pathway, an FIC block probably does not block the ON.

  • anesthesia
  • local
  • methods
  • nerve block

https://doi.org/10.1136/rapm-2021-102553

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    Footnotes

    • Twitter @JensBorglum

    • Contributors All authors have made substantial contributions to the conception or design of the manuscript and/or the acquisition of material (figures). All authors have been involved in drafting the work and revising it critically. All authors have approved the final version and agree to be accountable for all aspects of the work.

    • Funding The study was funded by the Salling Foundation, the Toyota Foundation Denmark, and the Health Research Foundation of the Central Denmark Region. The content is solely the responsibility of the authors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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    • PostScript
      Reply to Dr Bendtsen and colleagues
      De Q Tran Perada Kantakam Naraporn Maikong Apichat Sinthubua Pasuk Mahakkanukrauh Prangmalee Leurcharusmee
      Regional Anesthesia & Pain Medicine 2021; 46 832-833 Published Online First: 28 Apr 2021. doi: 10.1136/rapm-2021-102782