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Lateral Femoral Cutaneous Nerve Block
Aka: Lateral Femoral Cutaneous Nerve Block
- See Also
- Regional Anesthesia (Nerve Block)
- Local Skin Anesthesia
- Field Block
- Hematoma Block
- Digital Block
- Point of Care Ultrasound (POCUS)
- Anatomy: Landmarks (from Anterolateral to Posteromedial)
- Anterior Superior Iliac Spine
- Sartorius Muscle
- Inguinal Ligament
- Lateral Femoral Cutaneous Nerve (crosses under Inguinal Ligament)
- Iliacus Muscle
- Indications
- Diagnostic to differentiate Meralgia Paresthetica from other causes of anterolateral thigh pain
- Precautions
- See Regional Anesthesia (Nerve Block)
- Avoid injecting directly into nerves
- Preparation
- Needle: 27 gauge 1.5 inch
- Skin Preparation (e.g. Hibiclens or Betadine)
- See Regional Anesthesia
- Anesthetic
- See Regional Anesthesia for Anesthetic options
- Local Anesthetic 2-5 ml (Ultrasound) or 5-10 ml (landmark)
- Technique: Ultrasound-Guided (preferred)
- Patient position
- Supine position
- Ultrasound Probe
- Linear probe positioned transverse over the inguinal ligament
- Lateral probe border parallel with the anterior superior iliac spine (ASIS)
- Injection
- Needle inserted just lateral to the anterior superior iliac spine (ASIS)
- Needle directed in-plane (beneath the Ultrasound probe) at a 30 degree angle
- Inject at the perineural space
- Technique: Landmarks
- Patient position
- Supine position
- Identify landmarks
- Identify anterior superior iliac spine (ASIS)
- Injection
- Insert needle 2 cm medial and 2 cm distal to ASIS
- Angle the needle 30-45 degrees, directed toward the midline
- Advance the needle 1 cm and inject
- Warning: Distal Paresthesias with needle with injection
- Indicates needle is in nerve
- Do not inject here!
- Remove needle and reposition
- References
- Yurgil (2020) Am Fam Physician 101(11):654-64 [PubMed]