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Obturator Nerve Block: An Anatomical Perspective
Rajiv Ranjan1, Rita Kumari1, Babita Kujur1
1Anatomy, Rajendra Institute of Medical Sciences, Ranchi, IND.
Cureus
|May 28, 2024
Summary
Accurate obturator nerve block relies on understanding its anatomy. The pubic tubercle and inguinal ligament are the most reliable surface landmarks for locating the obturator nerve trunk.
Area of Science:
- Anatomy
- Regional Anesthesia
- Surgical Anatomy
Background:
- Effective obturator nerve blocks require precise anatomical knowledge of the nerve's path post-obturator foramen.
- Surface landmarks in the inguinal region are crucial for guiding obturator nerve localization.
Purpose of the Study:
- To offer detailed anatomical guidance for obturator nerve blocks using surface landmarks.
- To investigate the anatomical variability of the obturator nerve's position relative to bony and soft tissue landmarks.
Main Methods:
- A cross-sectional observational study involving 34 dissected embalmed cadaveric lower limbs.
- Investigation of obturator nerve localization concerning bony landmarks (pubic tubercle, anterior superior iliac spine), ligamentous landmarks (inguinal ligament), and soft tissue parameters (femoral artery, adductor longus).
Main Results:
- The pubic tubercle and inguinal ligament demonstrated the least variability and were identified as the most reliable palpable landmarks for the obturator nerve trunk.
- The adductor longus muscle exhibited the shortest, least variable distance from the obturator nerve exit, making it a reliable soft tissue parameter for localization.
Conclusions:
- Significant anatomical variability in obturator nerve localization contributes to challenges in regional anesthesia.
- The pubic tubercle and inguinal ligament are the most consistent and reliable landmarks for identifying the main obturator nerve trunk.
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