Anatomical considerations for obturator nerve block with fascia iliaca compartment block

Thomas Fichtner Bendtsen; Erik Morre Pedersen; Bernhard Moriggl; Peter Hebbard; Jason Ivanusic; Jens Børglum; Thomas Dahl Nielsen; Philip Peng

doi:10.1136/rapm-2021-102553

Anatomical considerations for obturator nerve block with fascia iliaca compartment block

Reg Anesth Pain Med. 2021 Sep;46(9):806-812. doi: 10.1136/rapm-2021-102553. Epub 2021 Apr 28.

Authors

Thomas Fichtner Bendtsen¹, Erik Morre Pedersen^{2

3}, Bernhard Moriggl⁴, Peter Hebbard⁵, Jason Ivanusic⁶, Jens Børglum⁷, Thomas Dahl Nielsen⁸, Philip Peng⁹

Affiliations

¹ Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark tfb@dadlnet.dk.
² Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
³ Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
⁴ Institute of Clinical and Functional Anatomy, Department of Anatomy, Histology and Embryology, Medical University of Innsbruck, Innsbruck, Austria.
⁵ Department of Anesthesia Northeast Health Wangaratta, Ultrasound Education Group, University of Melbourne, Wangaratta, Victoria, Australia.
⁶ Department of Anatomy and Physiology, University of Melbourne, Melbourne, Victoria, Australia.
⁷ Department of Anesthesiology and Intensive Care, Zealand University Hospital, Roskilde, Denmark.
⁸ Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
⁹ Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.

PMID: 33911025
DOI: 10.1136/rapm-2021-102553

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.

Keywords: anesthesia; local; methods; nerve block.

MeSH terms

Anesthesia, Conduction*
Fascia / diagnostic imaging
Humans
Injections
Nerve Block*
Obturator Nerve / diagnostic imaging