Femoral and lateral femoral cutaneous nerve block

Abstract

Blockade of the lateral femoral cutaneous and femoral nerves is most commonly performed to provide postoperative analgesia for procedures on the knee. It can also provide the sole anesthetic for quadriceps muscle biopsy in the patient at risk for malignant hyperthermia. Recent advancements in understanding pelvic and femoral anatomy have provided additional techniques to improve the clinical success rate of femoral and lateral femoral cutaneous nerve blocks. The relationship of the fascia lata and fascia iliaca to these nerves plays a key role in appropriate needle placement and spread of the local anesthetic injectate. Peripheral nerve stimulation has facilitated the teaching of these techniques and performance of femoral nerve blocks in children under general anesthesia. Continuous femoral catheter infusions have been performed successfully in both children and adults. With understanding of the relevant anatomy and appropriate patient selection, blocks of these nerves have been remarkably safe and effective.