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Journal of the Korean Academy of Rehabilitation Medicine 2010;34(6):638-642.
The Effect of Obturator Nerve Block in Cerebral Palsy under Sevoflurane Anesthesia with Face Mask.
Kim, Woo Jin , Park, Young Sook , Song, Byung Hwa , Chang, Hyun Jung , Ku, Do Yub , Bae, Jae Hyun , Park, Tae Sik
1Department of Physical Medicine and Rehabilitation, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 630-522, Korea. heiwon@medigate.net
2Department of Anesthesiology and Pain Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 630-522, Korea.
ObjectiveTo investigate the effect of obturator nerve block with 5% phenol under sevoflurane mask inhalation general anesthesia and its influence on vital signs in spastic cerebral palsy children during the procedure.

Method26 cerebral palsy children with spastic hip adductor muscles went under inhalation general anesthesia by anesthesiologist for phenol block of obturator nerve. After induction with thiopental sodium and sustained with sevoflurane by face mask without the use of muscle relaxant, the vital signs including heart rate, blood pressure and oxygen saturation were closely monitored throughout the procedure. The obturator nerve block was carried out with 5% phenol using a stimulator. Modified Ashworth scale (MAS) and range of motion of hip were measured before and after the procedure to compare the effects of nerve block.

No significant differences were observed from the vital signs before, during and after the procedure. The MAS score improved from average 2.50±0.71 to 1.12±0.32. The range of motion increased from 24.31±12.32o and 25.88±12.28o right and left relatively to 39.62±10.10o and 40.96±11.14o.

ConclusionBoth spasticity and range of motion of hip adductor muscles improved significantly after obturator nerve block with 5% phenol under inhalation general anesthesia in the operating room with face mask, and no adverse effects or complications were seen in all 26 cerebral palsy children. Therefore phenol nerve block under inhalation general anesthesia in operation room for cerebral palsy children with poor cooperation or positioning difficulty due to spasticity should be considered as a useful method.

Key Words: Spastic cerebral palsy, Obturator nerve, Nerve block, Anesthesia


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