Surgery Book


Femoral Nerve Block

Aka: Femoral Nerve Block
  1. See Also
    1. Fascia Iliaca Block
    2. PENG Regional Anesthesia
    3. Hip Fracture
    4. Regional Anesthesia (Nerve Block)
    5. Local Skin Anesthesia
    6. Field Block
    7. Hematoma Block
    8. Digital Block
    9. Point of Care Ultrasound (POCUS)
  2. Indications
    1. Regional Anesthesia covering proximal femur to knee
    2. Mid-shaft Femur Fracture
  3. Anatomy: Landmarks
    1. Palpate femoral artery
    2. Femoral nerve lies lateral to the artery (NAVL)
    3. Injection site is 1-2 cm below the inguinal ligament, lateral to the femoral nerve
    4. Consider Bedside Ultrasound to confirm needle placement (optional)
      1. Allows visualization of artery as well as fluid infiltrating and expanding the appropriate space
  4. Preparation
    1. Consider performing in conjunction with other procedures
      1. Consider prior to Hare Traction Splint application
      2. If applying splint under Conscious Sedation, consider simultaneously placing Femoral Nerve Block
    2. Anesthetic block options
      1. Bupivacaine or Sensorcaine: 10-20 cc (max 2 to 2.5 mg/kg) or
      2. Ropivacaine: 10-20 cc (max 2 mg/kg)
    3. Syringe
      1. Draw 10-20 cc Bupivicaine or Ropivacaine without Epinephrine into a 20 cc syringe
      2. Attach 22 gauge 1" to 1.25" needle
  5. Technique
    1. Prepare site
      1. Palpate the femoral artery
      2. Position the Ultrasound (if used)
        1. Linear vascular probe with indicator at 9:00
        2. Superior or cephalad to injection site
        3. Midline marker of probe lies over the femoral artery
      3. Mark injection site (inferior to inguinal ligament, and lateral to femoral artery)
      4. Betadine or Hibiclens prep of injection site
      5. Locally infitrate skin at injection site (e.g. Lidocaine 1% with Epinephrine)
    2. Femoral Nerve Block
      1. Insert needle perpendicular to skin (90 degrees)
      2. Advance needle until Paresthesias (withdraw until ceases) or approximate depth of femoral artery
      3. Aspirate to confirm not in vessel
      4. Inject 10-20 cc (fluid may be seen on Ultrasound infiltrating appropriate space)
  6. Pharmacokinetics
    1. Onset of action: Within 15 to 30 minutes
    2. Duration: Expect 3-8 hours of Regional Anesthesia with Bupivicaine (longer with Ropivicaine)
  7. References
    1. Roberts (1998) Clinical Procedures in Emergency Medicine, Saunders
    2. Sacchetti in Majoewsky (2012) EM:RAP 12(2): 4

Local anesthetic femoral nerve block (C0394739)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 231169005
English LA femoral nerve block, femoral nerve block, nerve block of femoral nerve (treatment), nerve block of femoral nerve, block femoral nerve, Femoral nerve block, Local anaesthetic femoral nerve block, Local anesthetic femoral nerve block, Local anesthetic femoral nerve block (procedure)
Spanish bloqueo de nervio crural con anestésico local (procedimiento), bloqueo con anestesia local de nervio crural, bloqueo con anestesia local de nervio crural (procedimiento), bloqueo de nervio crural con anestésico local
Derived from the NIH UMLS (Unified Medical Language System)

You are currently viewing the original '\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree