Augspurger R R, Donohue R E
J Urol. 1980 Feb;123(2):170-2. doi: 10.1016/s0022-5347(17)55837-1.
The obturator nerve passes in close proximity to the inferolateral bladder wall, bladder neck and lateral prostatic urethra. During a transurethral operation resection in these areas may result in stimulation of the obturator nerve, causing violent adductor contraction and possible inadvertent bladder perforation. To block this reaction d-tubocurarine and succinylcholine can be used during general anesthesia. However, it often is preferable to use spinal anesthesia during transurethral operations. Local anesthetic blockade of the obturator nerve as it passes through the obturator canal if effective for adductor spasm during spinal anesthesia. We herein describe the anatomy, pharmacology, technique and results of local obturator nerve blockade.
闭孔神经紧邻膀胱下外侧壁、膀胱颈和前列腺尿道外侧走行。在经尿道手术中，对这些区域进行切除可能会刺激闭孔神经，导致内收肌剧烈收缩，并可能意外造成膀胱穿孔。为了阻断这种反应，可在全身麻醉期间使用筒箭毒碱和琥珀酰胆碱。然而，在经尿道手术期间通常更宜采用脊髓麻醉。当闭孔神经穿过闭孔管时，对其进行局部麻醉阻滞可有效缓解脊髓麻醉期间的内收肌痉挛。我们在此描述局部闭孔神经阻滞的解剖学、药理学、技术及结果。
