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A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block

Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with f...

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Autores principales: ten Hoope, Werner, Smulders, Pascal S. H., Baumann, Holger M., Hermanides, Jeroen, Beenen, Ludo F. M., Oostra, Roelof-Jan, Marhofer, Peter, Lirk, Philipp, Hollmann, Markus W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372149/
https://www.ncbi.nlm.nih.gov/pubmed/37495606
http://dx.doi.org/10.1038/s41598-023-39041-5
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author ten Hoope, Werner
Smulders, Pascal S. H.
Baumann, Holger M.
Hermanides, Jeroen
Beenen, Ludo F. M.
Oostra, Roelof-Jan
Marhofer, Peter
Lirk, Philipp
Hollmann, Markus W.
author_facet ten Hoope, Werner
Smulders, Pascal S. H.
Baumann, Holger M.
Hermanides, Jeroen
Beenen, Ludo F. M.
Oostra, Roelof-Jan
Marhofer, Peter
Lirk, Philipp
Hollmann, Markus W.
author_sort ten Hoope, Werner
collection PubMed
description Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with five centimeters of hydrodissection-mediated needle advancement (S-FICB-H) on ON involvement and cranial injectate spread was studied in this radiological cadaveric study. Results were compared with suprainguinal FICB without additional hydrodissection-mediated needle advancement (S-FICB), infrainguinal FICB (I-FICB), and femoral nerve block (FNB). Seventeen human cadavers were randomized to receive ultrasound-guided nerve block with a 40 mL solution of local anesthetic and contrast medium, on both sides. Injectate spread was objectified using computed tomography. The femoral and lateral femoral cutaneous nerves were consistently covered when S-FICB-H, S-FICB or FNB was applied, while the ON was involved in only one of the 34 nerve blocks. I-FICB failed to provide the same consistency of nerve involvement as S-FICB-H, S-FICB or FNB. Injectate reached most cranial in specimens treated with S-FICB-H. Our results demonstrate that even the technique with the most extensive cranial spread (S-FICB-H) does not lead to ON involvement and as such, the ON seems unrelated to FICB. Separate ON block should be considered when clinically indicated.
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spelling pubmed-103721492023-07-28 A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block ten Hoope, Werner Smulders, Pascal S. H. Baumann, Holger M. Hermanides, Jeroen Beenen, Ludo F. M. Oostra, Roelof-Jan Marhofer, Peter Lirk, Philipp Hollmann, Markus W. Sci Rep Article Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with five centimeters of hydrodissection-mediated needle advancement (S-FICB-H) on ON involvement and cranial injectate spread was studied in this radiological cadaveric study. Results were compared with suprainguinal FICB without additional hydrodissection-mediated needle advancement (S-FICB), infrainguinal FICB (I-FICB), and femoral nerve block (FNB). Seventeen human cadavers were randomized to receive ultrasound-guided nerve block with a 40 mL solution of local anesthetic and contrast medium, on both sides. Injectate spread was objectified using computed tomography. The femoral and lateral femoral cutaneous nerves were consistently covered when S-FICB-H, S-FICB or FNB was applied, while the ON was involved in only one of the 34 nerve blocks. I-FICB failed to provide the same consistency of nerve involvement as S-FICB-H, S-FICB or FNB. Injectate reached most cranial in specimens treated with S-FICB-H. Our results demonstrate that even the technique with the most extensive cranial spread (S-FICB-H) does not lead to ON involvement and as such, the ON seems unrelated to FICB. Separate ON block should be considered when clinically indicated. Nature Publishing Group UK 2023-07-26 /pmc/articles/PMC10372149/ /pubmed/37495606 http://dx.doi.org/10.1038/s41598-023-39041-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
ten Hoope, Werner
Smulders, Pascal S. H.
Baumann, Holger M.
Hermanides, Jeroen
Beenen, Ludo F. M.
Oostra, Roelof-Jan
Marhofer, Peter
Lirk, Philipp
Hollmann, Markus W.
A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
title A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
title_full A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
title_fullStr A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
title_full_unstemmed A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
title_short A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
title_sort radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372149/
https://www.ncbi.nlm.nih.gov/pubmed/37495606
http://dx.doi.org/10.1038/s41598-023-39041-5
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