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Fascia Iliaca Compartment Block
Kimberly Ting, MD; Nicole Z. Spence, MD; Jason M. Lewis, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Abbreviations

              • Anterior superior iliac spine (ASIS)
              • Anterior inferior iliac spine (AIIS)
              • Fascia Iliaca compartment block (FICB)
              • Suprainguinal fascia iliaca block (SIFIB)
            • Synonyms

              • Fascia iliaca block (FIB)
            • Definitions

              • FICB targets femoral nerve, obturator never, lateral femoral cutaneous nerve (LFCN), and, less commonly, genitofemoral nerve
                • Nerves originate from lumbar plexus and located deep fascia iliaca in their intrapelvic course after emerging from substance of psoas
                  • Femoral nerve blockade
                    • Anesthesia of anterior thigh, medial leg, and foot
                    • Anesthesia of iliac crest, anterior femoral neck, anterior femur, and distal femur
                  • LFCN blockade
                    • Sensory blockade of lateral thigh
                  • Obturator nerve blockade
                    • Motor blockade of adductor muscles with sensory blockade of medial thigh
                    • Anesthesia to pubic ramus, medial femur, including medial epicondyle
                  • Genitofemoral nerve
                    • Motor blockade of cremasteric reflex
                    • Sensory blockade to anterior medial thigh
              • FIB is compartment block relying on spread of local anesthetic
              • FIB can be performed by ultrasound-guided technique or blind "double-pop" technique
                • Local anesthetic can be injected below inguinal ligament or above inguinal ligament (suprainguinal)
                • Suprainguinal results in more reliable blockade of LFCN, obturator nerve, and genitofemoral nerve

            PREPROCEDURE

            • Indications

              • Contraindications

                • Preprocedure Imaging

                  • Getting Started

                    PROCEDURE

                    • Patient Position/Location

                      • Equipment Preparation

                        • Procedure Steps

                          • Findings and Reporting

                            • Alternative Procedures/Therapies

                              POST PROCEDURE

                              • Expected Outcome

                                • Things To Do

                                  • Things To Avoid

                                    OUTCOMES

                                    • Problems

                                      • Complications

                                        Selected References

                                        1. O'Reilly N et al: Fascia iliaca compartment block. BJA Education, 19(6), 191-7, 2019
                                        2. Yamamoto N et al: Comparison of the postoperative analgesic efficacies of intravenous acetaminophen and fascia iliaca compartment block inhip fracture surgery: a randomised controlled trial. Injury. 50(10):1689-93, 2019
                                        3. Desmet M et al: A longitudinal supra-inguinal fascia iliaca compartment block reduces morphine consumption after total hip arthroplasty. Reg Anesth Pain Med. 42(3):327-33, 2017
                                        4. Yang L et al: Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis. J Pain Res. 10:2833-41, 2017
                                        5. Bang S et al: Efficacy of ultrasound-guided fascia iliaca compartment block after hip hemiarthroplasty: a prospective, randomized trial. Medicine (Baltimore). 95(39):e5018, 2016
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Preprocedure

                                            • Procedure

                                              • Post Procedure

                                                • Outcomes

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Anterior superior iliac spine (ASIS)
                                                    • Anterior inferior iliac spine (AIIS)
                                                    • Fascia Iliaca compartment block (FICB)
                                                    • Suprainguinal fascia iliaca block (SIFIB)
                                                  • Synonyms

                                                    • Fascia iliaca block (FIB)
                                                  • Definitions

                                                    • FICB targets femoral nerve, obturator never, lateral femoral cutaneous nerve (LFCN), and, less commonly, genitofemoral nerve
                                                      • Nerves originate from lumbar plexus and located deep fascia iliaca in their intrapelvic course after emerging from substance of psoas
                                                        • Femoral nerve blockade
                                                          • Anesthesia of anterior thigh, medial leg, and foot
                                                          • Anesthesia of iliac crest, anterior femoral neck, anterior femur, and distal femur
                                                        • LFCN blockade
                                                          • Sensory blockade of lateral thigh
                                                        • Obturator nerve blockade
                                                          • Motor blockade of adductor muscles with sensory blockade of medial thigh
                                                          • Anesthesia to pubic ramus, medial femur, including medial epicondyle
                                                        • Genitofemoral nerve
                                                          • Motor blockade of cremasteric reflex
                                                          • Sensory blockade to anterior medial thigh
                                                    • FIB is compartment block relying on spread of local anesthetic
                                                    • FIB can be performed by ultrasound-guided technique or blind "double-pop" technique
                                                      • Local anesthetic can be injected below inguinal ligament or above inguinal ligament (suprainguinal)
                                                      • Suprainguinal results in more reliable blockade of LFCN, obturator nerve, and genitofemoral nerve

                                                  PREPROCEDURE

                                                  • Indications

                                                    • Contraindications

                                                      • Preprocedure Imaging

                                                        • Getting Started

                                                          PROCEDURE

                                                          • Patient Position/Location

                                                            • Equipment Preparation

                                                              • Procedure Steps

                                                                • Findings and Reporting

                                                                  • Alternative Procedures/Therapies

                                                                    POST PROCEDURE

                                                                    • Expected Outcome

                                                                      • Things To Do

                                                                        • Things To Avoid

                                                                          OUTCOMES

                                                                          • Problems

                                                                            • Complications

                                                                              Selected References

                                                                              1. O'Reilly N et al: Fascia iliaca compartment block. BJA Education, 19(6), 191-7, 2019
                                                                              2. Yamamoto N et al: Comparison of the postoperative analgesic efficacies of intravenous acetaminophen and fascia iliaca compartment block inhip fracture surgery: a randomised controlled trial. Injury. 50(10):1689-93, 2019
                                                                              3. Desmet M et al: A longitudinal supra-inguinal fascia iliaca compartment block reduces morphine consumption after total hip arthroplasty. Reg Anesth Pain Med. 42(3):327-33, 2017
                                                                              4. Yang L et al: Fascia iliaca compartment block versus no block for pain control after lower limb surgery: a meta-analysis. J Pain Res. 10:2833-41, 2017
                                                                              5. Bang S et al: Efficacy of ultrasound-guided fascia iliaca compartment block after hip hemiarthroplasty: a prospective, randomized trial. Medicine (Baltimore). 95(39):e5018, 2016