Ultrasound guidance in obturator nerve block in lower limb spasticity

Background and objectives: The obturator nerve has been the subject of several studies due to its varied anatomical location & accessory branches. This nerve can be blocked at proximal and distal levels. Better visualization of the nerve may improve safety and success of the block. In our study ultrasound was used along with peripheral nerve stimulator for blocking the obrurator nerve divisions distally in the patients suffering from adductor muscle spasticity. Methods: Twenty patients suffering from adductor spasticity were administered onbturator block after written informed consent. Nerve stimulating needle was directed in plane under real time ultrasound. End point for injection consisted of identifying the contact of insulated needle tip to nerve confirmed by adductor muscle contraction. 3 ml of 6% phenol was injected at each division. The parameters evaluated were Modified Ashworth Scale of the spasticity, range of motion of the hip abductors by goniometer, pain, number of spasms, hygiene score. These were re-evaluated at the 1st & 24th hour, first week and the first, second and third months.