Jens Aage Kølsen Petersen

A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches

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A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches. / Nielsen, Thomas D.; Moriggl, Bernhard; Soballe, Kjeld et al.

I: Regional Anesthesia and Pain Medicine, Bind 42, Nr. 3, 2017, s. 357-361.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Nielsen TD, Moriggl B, Soballe K, Kolsen-Petersen JA, Borglum J, Bendtsen TF. A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches. Regional Anesthesia and Pain Medicine. 2017;42(3):357-361. doi: 10.1097/AAP.0000000000000587

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Nielsen, Thomas D. ; Moriggl, Bernhard ; Soballe, Kjeld et al. / A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches. I: Regional Anesthesia and Pain Medicine. 2017 ; Bind 42, Nr. 3. s. 357-361.

Bibtex

@article{8842a4816a92432791d58a9d8e1791a8,
title = "A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches",
abstract = "Background and Objectives: The femoral and obturator nerves are assumed to account for the primary nociceptive innervation of the hip joint capsule. The fascia iliaca compartment block and the so-called 3-in-1-block have been used in patients with hip fracture based on a presumption that local anesthetic spreads to anesthetize both the femoral and the obturator nerves. Evidence demonstrates that this presumption is unfounded, and knowledge about the analgesic effect of obturator nerve blockade in hip fracture patients presurgically is thus nonexistent. The objectives of this cadaveric study were to investigate the proximal spread of the injectate resulting from the administration of an ultrasound-guided obturator nerve block and to evaluate the spread around the obturator nerve branches to the hip joint capsule.Methods: Fifteen milliliters of methylene blue was injected into the interfascial plane between the pectineus and external obturator muscles in 7 adult cadavers. The spread of the injectate into the obturator canal and around the obturator and accessory obturator nerve branches to the hip joint was evaluated by subsequent dissection.Results: The injected dye spread into the obturator canal and colored all obturator branches to the hip joint capsule in all 14 sides. Furthermore, the accessory obturator nerve was present in 3 sides (21%), and the nerve and its branches to the hip joint capsule were colored in all cases.Conclusions: In cadavers, injection of 15 mL of methylene blue into the interfascial plane between the pectineus and the external obturator muscle effectively spreads proximally to reach the obturator canal, as well as the obturator nerve branches to the hip joint capsule and the accessory obturator nerve.",
keywords = "TOTAL KNEE ARTHROPLASTY, FASCIA ILIACA, 3-IN-1 BLOCK, INNERVATION, JOINT",
author = "Nielsen, {Thomas D.} and Bernhard Moriggl and Kjeld Soballe and Kolsen-Petersen, {Jens A.} and Jens Borglum and Bendtsen, {Thomas Fichtner}",
year = "2017",
doi = "10.1097/AAP.0000000000000587",
language = "English",
volume = "42",
pages = "357--361",
journal = "Regional Anesthesia and Pain Medicine",
issn = "1098-7339",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "3",

}

RIS

TY - JOUR

T1 - A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches

AU - Nielsen, Thomas D.

AU - Moriggl, Bernhard

AU - Soballe, Kjeld

AU - Kolsen-Petersen, Jens A.

AU - Borglum, Jens

AU - Bendtsen, Thomas Fichtner

PY - 2017

Y1 - 2017

N2 - Background and Objectives: The femoral and obturator nerves are assumed to account for the primary nociceptive innervation of the hip joint capsule. The fascia iliaca compartment block and the so-called 3-in-1-block have been used in patients with hip fracture based on a presumption that local anesthetic spreads to anesthetize both the femoral and the obturator nerves. Evidence demonstrates that this presumption is unfounded, and knowledge about the analgesic effect of obturator nerve blockade in hip fracture patients presurgically is thus nonexistent. The objectives of this cadaveric study were to investigate the proximal spread of the injectate resulting from the administration of an ultrasound-guided obturator nerve block and to evaluate the spread around the obturator nerve branches to the hip joint capsule.Methods: Fifteen milliliters of methylene blue was injected into the interfascial plane between the pectineus and external obturator muscles in 7 adult cadavers. The spread of the injectate into the obturator canal and around the obturator and accessory obturator nerve branches to the hip joint was evaluated by subsequent dissection.Results: The injected dye spread into the obturator canal and colored all obturator branches to the hip joint capsule in all 14 sides. Furthermore, the accessory obturator nerve was present in 3 sides (21%), and the nerve and its branches to the hip joint capsule were colored in all cases.Conclusions: In cadavers, injection of 15 mL of methylene blue into the interfascial plane between the pectineus and the external obturator muscle effectively spreads proximally to reach the obturator canal, as well as the obturator nerve branches to the hip joint capsule and the accessory obturator nerve.

AB - Background and Objectives: The femoral and obturator nerves are assumed to account for the primary nociceptive innervation of the hip joint capsule. The fascia iliaca compartment block and the so-called 3-in-1-block have been used in patients with hip fracture based on a presumption that local anesthetic spreads to anesthetize both the femoral and the obturator nerves. Evidence demonstrates that this presumption is unfounded, and knowledge about the analgesic effect of obturator nerve blockade in hip fracture patients presurgically is thus nonexistent. The objectives of this cadaveric study were to investigate the proximal spread of the injectate resulting from the administration of an ultrasound-guided obturator nerve block and to evaluate the spread around the obturator nerve branches to the hip joint capsule.Methods: Fifteen milliliters of methylene blue was injected into the interfascial plane between the pectineus and external obturator muscles in 7 adult cadavers. The spread of the injectate into the obturator canal and around the obturator and accessory obturator nerve branches to the hip joint was evaluated by subsequent dissection.Results: The injected dye spread into the obturator canal and colored all obturator branches to the hip joint capsule in all 14 sides. Furthermore, the accessory obturator nerve was present in 3 sides (21%), and the nerve and its branches to the hip joint capsule were colored in all cases.Conclusions: In cadavers, injection of 15 mL of methylene blue into the interfascial plane between the pectineus and the external obturator muscle effectively spreads proximally to reach the obturator canal, as well as the obturator nerve branches to the hip joint capsule and the accessory obturator nerve.

KW - TOTAL KNEE ARTHROPLASTY

KW - FASCIA ILIACA

KW - 3-IN-1 BLOCK

KW - INNERVATION

KW - JOINT

U2 - 10.1097/AAP.0000000000000587

DO - 10.1097/AAP.0000000000000587

M3 - Journal article

C2 - 28263244

VL - 42

SP - 357

EP - 361

JO - Regional Anesthesia and Pain Medicine

JF - Regional Anesthesia and Pain Medicine

SN - 1098-7339

IS - 3

ER -