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July 18, 2017

Femoral Nerve Block Article

By Dr Jacinth Tan Fast, safe and effective procedure. In patients undergoing surgery: Reduces the amount of general anaesthetic and opioid…

By Dr Jacinth Tan

  • Fast, safe and effective procedure.
  • In patients undergoing surgery: Reduces the amount of general anaesthetic and opioid analgesics needed intraoperatively1, reduces post-operative pain and analgesic consumption1, 2, and may even reduce the length of hospital stay2.
  • In patients not undergoing surgery: Reduces the pain from hip fractures, provides longer duration of analgesia, reduces the analgesic doses needed and reduces the number of nursing interventions3.

Indications:

Surgical procedures to:

  • Hip joint.
  • Femur (e.g. femoral fractures)4.
  • Knee (e.g. knee arthroscopies, ACL reconstructions, patella ligament realignment)4:
  • For anterior knee procedures: A femoral nerve block alone may suffice4
  • For coverage of the medial aspect of the knee: Obturator nerve block should be added4
  • For coverage of the lateral aspect of the knee: Lateral femoral cutaneous nerve block should be added4
  • For coverage of the posterior aspect of the knee: Sciatic nerve block should be added4
  • Anterior thigh (e.g. skin graft from the anterior aspect of the thigh) 5.
  • Medial aspect of the leg (by blocking the saphenous nerve—a terminal cutaneous branch of the femoral nerve).
  • In combination with a popliteal block, analgesia can be provided for any procedure on the lower leg and foot5.
  • In combination with a high sciatic block and an obturator nerve block, analgesia can be provided for the entire lower extremity5.

Contraindications:

  • Local infection at the proposed needle insertion point.
  • Situations where dense sensory block may mask the onset of lower extremity compartment syndrome (especially if combined with a sciatic block). E.g. Fresh fractures of the tibia/ fibula, or extensive and traumatic elective orthopaedic procedures to the tibia and fibula. Best practice will be to consult with one’s surgical colleagues as to the likelihood of compartment syndrome.6

Read the full article HERE.