Femoral Nerve Block

Femoral Nerve Block Shaded Area Illustration

The femoral nerve block is a regional anesthesia technique that is performed at the level of the femoral crease. It can be beneficial for a variety of surgical procedures involving the anterior thigh and knee, including:

  • Patellar tendon repair
  • Quadriceps tendon repair
  • Patellar fractures
  • Femur fractures
  • Femoral neck fractures
  • ACL repair

Overview of the Femoral Nerve Block

This block provides analgesia to the anterior thigh, anteromedial knee, and the medial aspect of the lower leg, ankle, and foot. Articular branches arising from the femoral nerve innervate the hip and knee joints, while muscular branches provide motor innervation to the quadriceps muscle. The femoral nerve block can be performed along with a sciatic and obturator nerve block to provide complete coverage of the lower extremity.

Risks and Side Effects

Any procedure that involves anesthesia comes with its own set of risks. Some risks and complications involving a femoral nerve block may include:

  • Allergic reaction
  • Infection
  • Intravascular injection
  • Local anesthetic systemic toxicity (LAST)
  • Hematoma
  • Nerve injury
  • Falling risk due to quadriceps weakness

How to Perform the Femoral Nerve Block

To perform the block, place the patient in a supine position. The ultrasound transducer is placed in a transverse position along the inguinal crease and slid in a medial and lateral direction to identify the femoral artery and vein.  The femoral nerve will be located lateral to the femoral artery and posterior to the fascia iliaca. Insert the block needle through the skin 1-2cm lateral to the transducer and advance in-plane using a lateral to medial direction until the needle tip passes through the fascia iliaca and is adjacent to the nerve. After negative aspiration, inject 1-2ml of local anesthetic to confirm needle tip location. Administer up to 20ml of local anesthetic.  Reposition the needle as necessary to help facilitate spread of local anesthetic around the nerve. For a more comprehensive review of this block, including a detailed video, use the Block Buddy Pro app.

Get Complete Instructions in the Block Buddy Pro App

Block Buddy Pro is the most notable and accessible resource to support anesthesia providers in administering ultrasound-guided nerve blocks. The Femoral Nerve Block Lesson in the Block Buddy Pro app includes:

  • Foolproof instructions
  • Detailed anatomy breakdown
  • 13 images consisting of detailed illustrations, ultrasound images, and photos from inside the operating room.
  • A guided video with step-by-step instructions.

By downloading the app, you will also gain access to an array of detailed block lessons. The app features an interactive notes section, and is usable offline! Block Buddy Pro is available on all devices (mobile, tablet, and desktop) and can be purchased in the App Store and Google Play Store. To get started, simply create your account now!