Lower limb

LOWER LIMB BLOCKS WITH NERVE STIMULATOR
Femoral Nerve Block       Three in one Nerve Block      Lateral Femoral Cutaneous Nerve
Obturator Nerve            Popleteal Block            Classic approach for sciatic nerve block
Sciatic Nerve Block Anterior approach          Ankle Block         Saphenous Nerve Block
Dr.R.Silamban(Asst. Professor)

FEMORAL NERVE BLOCK
Position:Supine
Site of Needle Entry:A point 2 cms below the inguinal ligament and 1cm lateral to the femoral artery.
Technique:A 4cm needle is entered at the above point perpendicular to the skin to pierce the iliopectineal fascia and fascia lata and parasthesia is elicited. If nerve locator is used the motor response depends on division of the femoral nerve that is stimulated. If the anterior division is stimulated the vasti respond. It is always better to have a motor response of the posterior division for a complete block especially if surgery is around the knee joint.
After the first injection of the drug the needle is removed and again entered into the skin from a site 1 cm lateral to the previous point and the needle is directed to lie below the femoral artery. About 8 ml of drug is injected here. This ensures the posterior division is always blocked.
Volume: 20ml
Pearls:
In 20% of individuals the nerve divides above the inguinal ligament. In such circumstances separate block of the posterior division is very vital
Continous catheter can be placed here
Very useful for acute pain relief in femur fractures.
Posted in REGIONAL ANAESTHESIA

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