Combined sub-iliopsoas and subpectineal blocks-for hip surgery

Patent metadata

Field	Value
Publication number	US-2022015738-A1
Application number	US-202016930810-A
Country	US
Kind code	A1
Filing date	Jul 16, 2020
Priority date	Jul 16, 2020
Publication date	Jan 20, 2022
Grant date	—

Abstract

A method for applying a regional block of the articular sensory branch of femoral (FN), obturator (ON) and accessory obturator nerves (AON) comprising injection of an anesthetic at a single needle entry point into a these nerves anatomical sites. Another aspect of this technology is a kit for performing this method.

First claim

1 . A method for inducing a regional block comprising the articular branches of the femoral nerve (FN), the obturator nerve (ON), and the accessory obturator nerve (AON), in a subject, the method comprising:
injecting an anesthetic via a single needle entry point into a region around the high articular femoral branch and then changing the angle and direction of the single needle to inject the anesthetic around the obturator nerve stem, under guidance of a curvilinear ultrasound probe which provides a view of the regions containing the nerves to be injected.

2 . The method of claim 1 , wherein the regional block simultaneously blocks the high femoral and obturator nerve stems prior to their branching into anterior and posterior branches.

3 . The method of claim 1 , wherein the regional block blocks the nerve supply to the anterior capsule of the hip.

4 . The method of claim 1 , wherein the regional block blocks the articular branches of the femoral nerve and obturator nerve in one sonoanatomical frame with minimal or without requiring movement of the curvilinear probe.

5 . The method of claim 1 , wherein the regional block comprises combined sub-iliopsoas and sub-pectineal blocks.

6 . The method of claim 1 , wherein the regional block is higher and above femoral crease than a conventional femoral nerve block done lateral to femoral artery and below the femoral crease.

7 . The method of claim 1 , wherein the regional block directly blocks the stem of obturator nerve before it branches into anterior and posterior divisions.

8 . The method of claim 1 , wherein the regional block only blocks the sensory articular branch of the femoral nerve.

9 . The method of claim 1 , wherein an amount of opiate or other parenteral analgesics administered for intraoperative or post-operative pain control is reduced compared to that administered after a conventional femoral nerve block done lateral to the femoral artery.

10 . The method of claim 1 , wherein the subject experiences no or minimal motor blocks after the regional block is established.

11 . The method of claim 1 , wherein the regional block involves identification of anatomical landmarks and avoids a central neuraxial (spinal/epidural) block.

12 . The method of claim 1 , wherein the subject experiences substantially no/minimal dysfunction of the bladder after the regional block is established.

13 . The method of claim 1 , wherein the regional block is administered peri-operatively to a subject who has undergone a total hip arthroplasty.

14 . The method of claim 1 , wherein the regional block is administered peri-operatively to a subject who has undergone a partial hip arthroplasty.

15 . The method of claim 1 , wherein the regional block is administered to a subject who has a hip fracture.

16 . The method of claim 1 , wherein the regional block is applied to relieve adductor muscle spasm associated with hemiplegia or paraplegia.

17 . A method of using a curvilinear ultrasound probe to image in one sonoanatomical frame a femoral nerve (FN), obturator nerve (ON) and accessory obturator nerve (AON) comprising placing the curvilinear ultrasound probe over an anatomical location of these nerves and, optionally, selecting a single entry point on the skin of a subject for injection of an anesthetic around the FN and ON, or around the FN, ON and AON.

18 . A kit comprising at least one curvilinear ultrasound probe, needle suitable for injection an anesthetic around a femoral nerve (FN) and obturator nerve (ON), or around the FN, ON and accessory obturator nerve (AON), a syringe, and an anesthetic suitable for producing a nerve block.

19 . The kit of claim 18 , further comprising at least one of a sterile packaging or tray for the needle, syringe and other kit components, antiseptic, surgical gloves, swabs, gauze, bandages, packaging materials for the kit, instructions for selecting a single entry point for the needle using the kit, and/or instructions for performing a single entry point injection of the anesthetic around the FN and ON, or around the FN, ON and AON to produce the nerve block.

Assignees

• Nat Guard Health Affairs
• King Saud Bin Abdulaziz Univ For Health Sciences
• King Abdullah International Medical Res Center

Inventors

• Harbi Mohammed Al
• Guru Rahul
• Sharma Sheelaj
• Al Attas Khaled

Classifications

• A61K31/485

  Morphinan derivatives, e.g. morphine, codeine · CPC title

• A61B8/4455

  Features of the external shape of the probe, e.g. ergonomic aspects · CPC title

• A61B8/085 Primary

  for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules · CPC title

• A61B8/4494

  characterised by the arrangement of the transducer elements · CPC title

• A61B8/0841

  for locating instruments · CPC title