Femoral Nerve Block

Rapid Summary

5 Minute Video

When to block:

Patients presenting with:
• Hip Fractures (excluding subcapital fractures)
• Femoral Fractures

Amount of anesthetic:

• ~20cc 0.5% bupivacaine (Femoral Nerve Block)
• ~40cc 0.25% bupivacaine (Fascia Iliaca Block)
• Bupivacaine max dose: 2-2.5mg/kg (175mg/dose)

Use sterile/semi-sterile technique.
Monitor patient on cardiac monitor for 30-60min (re LAST).

Where you put the probe and needle:

• Inguinal Crease
• Use in plane technique with lateral to medial approach of the needle

Internal Landmarks:
• Femoral Nerve is lateral to Artery and Vein
• Locate femoral nerve above femoral artery bifurcation

• Purple line: Fascia Lata
• Blue line: Fascia Iliaca
• Red circle: Femoral artery
• Yellow oval: Femoral nerve

COMPRESS GIF 10 FPS DEIDENTIFIED MP4 14.54.08 hrs __[0003503]

• Needle entry lateral to iliopsas, in-plane
• Local anesthetic is injected under the fascia iliaca at a safe distance from the neurovascular bundle
• The needle tip can be 1-2 cm away from the nerve, just ensure anesthesia is spreading in the correct fascial plane!

COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.14 hrs __[0006680]

• Needle tip at fascia iliaca

COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.52 hrs __[0006681]

• Injecting anesthetic deep to fascia lata and fascia iliaca (lateral to artery and nerve)