Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942003000400010
Brazilian Journal of Anesthesiology
Artigos Diversos

Critérios de avaliação do bloqueio anestésico 3 em 1: É comum o envolvimento do nervo obturador?

Evaluation criteria for 3-in-1 anesthetic block: Is the involvement of the obturator nerve common?

Karl Otto Geier

http://dx.doi.org/10.1590/S0034-70942003000400010 Braz J Anesthesiol, vol.53, n4, p.501-511, 2003
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Resumo

JUSTIFICATIVA E OBJETIVOS: No bloqueio 3:1 é controvertida a participação do nervo obturador. Intervenções cirúrgicas de superfície na face medial da coxa incidem sobre os dermátomos dos nervos femoral e obturador, de limites imprecisos, sobrepostos ou mesmo ausentes. A correlação entre o desfecho clínico com outros meios de diagnóstico podem ser conclusivos sobre o acometimento do nervo obturador. CONTEÚDO: Comumente o desfecho de um bloqueio regional é pesquisado mais pela insensibilidade dos dermátomos que a atividade motora dos miótomos. A partir de conhecimentos anatômicos sobre o percurso dos componentes plexulares do bloqueio 3:1, critérios clínicos complementados por outros meios de diagnóstico esclarecem o envolvimento do nervo obturador. CONCLUSÕES: A simbiose entre o desfecho clínico do bloqueio 3:1 com os diversos meios de complementação diagnóstica são interpretativos e conclusivos e, de acordo com o que a literatura nos indica sobre a participação do nervo obturador, o bloqueio 3:1 com injeção única, não justifica o seu nome.

Palavras-chave

TÉCNICAS ANESTÉSICAS, TÉCNICAS ANESTÉSICAS

Abstract

BACKGROUND AND OBJECTIVES: The participation of the obturator nerve in 3:1 blockades is controversial. Superficial surgical interventions in the medial face of the thigh strike femoral and obturator nerves dermatomes with imprecise, overlapped or even absent limits. The correlation between clinical outcome and other diagnostic methods may be conclusive about the involvement of the obturator nerve. CONTENTS: In general, regional block outcomes are confirmed more by the lack of dermatome sensitivity than by miotomes motor activity. As from the anatomic understanding of the pathway of plexus components of 3:1 blocks, clinical criteria aided by other diagnostic methods explain obturator nerve involvement. CONCLUSIONS:The symbiosis between 3:1 block outcome and different diagnostic methods is interpretative and conclusive and, according to literature indications about the obturator nerve participation, 3:1 block with single injection does not justify its name.

Keywords

ANESTHETIC TECHNIQUES, ANESTHETIC TECHNIQUES

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