Clinical evaluation of obturator nerve involvement following a supra-inguinal fascia iliaca compartment block: A randomized, double-blind trial
Authors' conclusion
An SFICB with 40 mL of 0.5% ropivacaine rarely anesthetized the obturator nerve. The addition of a selective ONB did not improve postoperative analgesia or recovery quality within 48 h after total knee arthroplasty.
Study context
- Population
- Patients undergoing total knee arthroplasty under spinal anaesthesia
- Participants
- 84 patients
- Comparison
- SFICB plus active obturator nerve block (ONB) vs SFICB plus placebo ONB
- Primary endpoint
- (1) Success rate of ONB, 45 min after block completion; (2) equivalent IV morphine consumption, first 24 h postoperatively (predefined fixed-sequence procedure)
Methodological detailsdouble-blind, active-controlled, fixed-sequence testing of two primary outcomes, Spinal anaesthesia and postoperative analgesia standardized
- Double-blind
- Active-controlled
- Fixed-sequence testing of two primary outcomes
- Spinal anaesthesia and postoperative analgesia standardized
Primary result
As reported in the abstract
ONB success rate (45 min after block completion); equivalent IV morphine consumption first 24 h postoperatively
ONB
97.6%
Placebo
2.4%
ONB
6.8
median · IQR 2.5–11.5 · mg
Placebo
7.8
median · IQR 4.6–17.5 · mg
ONB vs PlaceboEstimate (95% CI)P value
ONB success rate
risk difference 95.2%(81.2%–98.0%)
P < 0.001Morphine consumption first 24 h; no significant difference
median difference −2.5(−5.0 to 0.5)
P = 0.156Secondary outcomes
Post-block sensorimotor function, pain scores, rescue analgesia, satisfaction, sleep quality, recovery quality (within 48 h)
- No differences, except a greater reduction in adductor strength in the ONB group
Original publication
Clinical evaluation of obturator nerve involvement following a supra-inguinal fascia iliaca compartment block: A randomized, double-blind trial. J Clin Anesth. Published 27 March 2026. doi:10.
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