PDF(Pubmed)
Abstract：
Background A comprehensive understanding of the anatomy of the obturator nerve after its emergence from the obturator foramen is essential when undertaking an obturator nerve block effectively. This study was conducted to provide precise anatomical guidance of the obturator nerve block with surface landmarks in the inguinal region. Materials and methods A cross-sectional observational study was carried out on 34 dissected embalmed cadaveric lower limbs to investigate anatomic variability of obturator nerve localization concerning bony/ligamentous landmarks viz. the pubic tubercle, anterior superior iliac spine, inguinal ligament, and femoral artery as well as the adductor longus. Results The pubic tubercle and inguinal ligament were found to be the \"least variable indicator\" and palpable landmark for localization of the main trunk of the obturator nerve exhibiting lesser standard deviation of the mean distance from the obturator nerve exit. Among the soft tissue (vessel/muscle) parameters, the shortest distance of the adductor longus muscle from the obturator nerve exit was found to have the lowest standard deviation, thus making it the most reliable parameter for obturator nerve localization. Conclusion High anatomic variability in the obturator nerve\'s localization does exist, and this explains the difficulty frequently encountered in the application of regional anesthetic techniques. The pubic tubercle and inguinal ligament points were found to be the least variable and most reliable landmarks for localization of the main trunk of the obturator nerve.
摘要：
背景技术当有效地进行闭孔神经阻滞时,对其从闭孔孔出现后的闭孔神经的解剖结构的全面理解是至关重要的。进行这项研究是为了对腹股沟区域具有表面标志的闭孔神经阻滞提供精确的解剖学指导。材料与方法对34例解剖的尸体下肢进行了横断面观察研究，以研究有关骨/韧带标志的闭孔神经定位的解剖变异性。耻骨结节,髂前上棘,腹股沟韧带,股动脉和长内收肌.结果耻骨结节和腹股沟韧带被发现是闭孔神经主干定位的“最小可变指标”和明显标志，与闭孔神经出口的平均距离的标准偏差较小。在软组织（血管/肌肉）参数中，发现长内收肌与闭孔神经出口的最短距离具有最低的标准偏差，从而使其成为闭孔神经定位最可靠的参数。结论闭孔神经定位存在高度的解剖变异性,这解释了区域麻醉技术应用中经常遇到的困难。发现耻骨结节和腹股沟韧带点是定位闭孔神经主干的变化最小，最可靠的标志。
