Sarah Razaq, Fahim Anwar, Muhammad Aleem Arshad.
Obturator Nerve Block with Aqueous Phenol Reduces Hip Adductor Spasticity - a Single Centre experience.
Pak J Neurological Sci Dec ;15(4):30-5.

Aim: Spasticity is a cardinal symptom of upper motor neuron disorders. It affects different individuals differently. Spasticity in the hip adductor muscles can be very painful and may result in postural abnormalities and hip deformities that interfere with walking, transferring and perineal hygiene. The study aimed to assess the effectiveness of phenol obturator nerve block on hip adductor spasticity caused by the upper motor neuron lesions. Materials and methods: This is a single-centre retrospective study of all patients with known spasticity in the hip adductors who were assessed suitable for phenol nerve block of the obturator nerve. All patients had Modified Ashworth Scale (MAS) and the distance between the right and left femoral condyles measured in the supine position with the hip and knee flexed called as intercondylar distance (ICD) recorded before the procedure, 6 weeks and 24 weeks after phenol nerve block. Nonparametric Friedman test of differences among repeated measures was conducted from data at 0, 6 and 24 weeks. RESULTS: Obturator nerve block was performed in 52 patients using 5% aqueous phenol. The procedure was bilateral in 38 patients and unilateral in 14 patients. There were 18 males and 34 females. There was a statistically significant difference between pre-injection MAS and intercondylar distance at 6 weeks and 24 weeks. Conclusion: Phenol neurolysis of the obturator nerve helps in reducing hip adductor spasticity and helps in improving positioning and hygiene. With appropriate training, the procedure is simple and easy to perform without major complications. KEYWORDS: Spasticity, Phenol, Neurolysis, Obturator nerve block

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