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Ultrasound-guided obturator nerve block

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For a block of the obturator nerve, the leg is positioned almost identically as for a femoral block. Nota bene: It often makes sense to combine the two blocks with one another, for example when a psoas block is impossible or undesirable. Starting from the „femoral position“, the transducer is advanced medially within the groin. The obturator nerve, whose ventral and dorsal branches lie respectively on top of and below the short adductor muscle, is covered by the pectineal and adductor longus muscles.

 

The Technique

Puncture is preferably carried out in-plane from lateral to medial, avoiding the femoral vein. The branches of the obturator nerve are irrigated under visual control with a few millilitres of local anaesthetic.

 

Sonoanatomic Landmarks

Femoral artery and vein, pectineal muscle, long and short adductor muscles

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