Femoral nerve blocks: the Ultrasound Podcast way!

Hopefully, many of you will have read my post from last year on fascia iliaca blocks for fractured neck of femur patients, it certainly has been one of the most popular posts I’ve written. I think these blocks were great, love doing them, and I make no apologies for my enthusiasm for this procedure.

However, I have discovered two docs from the USA whose love for all things ultrasound eclipses even mine. I’m talking of course about the Ultrasound Podcast guys. If you haven’t seen their videos yet, I can’t recommend them highly enough.

I loved their latest post on femoral nerve blockade, and wanted to talk about it quickly here. The technique they describe is different to the one I have been using; but it’s explained with such clarity and enthusiasm that I immediately wanted to go and try it out.

They describe using an in plane approach, with the probe positioned across the inguinal ligament to give us that familiar N-A-V view. They then introduce the needle in plane with the probe from the lateral aspect, aiming to place the local under the fascia ilaca, as close to the femoral nerve as possible. If I’m not making it very clear here, go and watch the video!

I can see two advantages to this approach.

Firstly, the needle is in plane with the ultrasound beam, and introduced at a much shallower angle, making it easier to keep that all important sharp end of the needle in view.

Also, this approach means you can place the local right next to the nerve. The podcast suggests that this means you don’t need the large volume we are used to using for this block.

Sounds great doesn’t it? I can’t wait to try this out. Many thanks to the Ultrasound Podcast guys for all the great work they do!



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