Bookmarks
KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Abbreviations
- Femoral nerve (FN)
- Femoral vein (FV)
- Femoral nerve block (FNB)
- Saphenous nerve (SN)
Definitions
- FN: Largest branch of lumbar plexus and is derived from anterior rami of L2, L3, L4
- FN is motor and sensory nerve
- Motor: Contributes to hip flexion by innervating pectineus, iliacus, sartorius muscles; responsible for knee extension by innervating vastus medialis, vastus lateralis, vastus intermedius
- Sensory: Anterior cutaneous branches of FN (sensory to anteromedial thigh) and terminal cutaneous branch of FN is SN (sensory to medial leg and foot)
- FN osteotome
- FN and its distal branch is responsible for sensory innervation (osteotome) of medial and anterior distal portion of femur
- In addition, FN provides sensation to anteromedial tibia and medial malleolus
- FNB can be performed by landmark technique with nerve stimulator or ultrasound-guided technique after FN courses underneath inguinal ligament to enter femoral triangle
- Femoral triangle borders
- Superior (base): Inguinal ligament
- Lateral: Sartorius muscle (medial margin)
- Medial: Adductor longus muscle (lateral margin)
- Apex: Sartorius muscle and adductor magnus muscle
- Floor: Iliopsoas, pectineus, adductor longus muscle
- Anterior: Fascia iliaca
- FNB (combined with sciatic nerve block) can provide complete anesthesia and analgesia for procedures of ipsilateral lower extremity
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
- Angers M et al: Negative influence of femoral nerve block on quadriceps strength recovery following total knee replacement: a prospective randomized trial. Orthop Traumatol Surg Res. 105(4):633-7, 2019
- Dimaculangan D et al: Periarticular injection and continuous femoral nerve block versus continuous femoral nerve block alone on postoperative opioid consumption and pain control following total knee arthroplasty: Randomized controlled trial. J Clin Orthop Trauma. 10(1):81-6, 2019
- Li J et al: A practical analgesia approach to fragility hip fracture: a single-center, retrospective, cohort study on femoral nerve block. J Orthop Trauma. 33(4):175-9, 2019
- Lynch JR et al: Adductor canal block versus femoral nerve block for pain control after anterior cruciate ligament reconstruction: a prospective randomized trial. Am J Sports Med. 47(2):355-63, 2019
- Ohgoshi Y et al: Use of IPACK block with continuous femoral triangle block for total knee arthroplasty: a clinical experience. J Clin Anesth. 54:52-4, 2019
- Zhao XY et al: Ultrasound-guided continuous femoral nerve block with dexmedetomidine combined with low concentrations of ropivacaine for postoperative analgesia in elderly knee arthroplasty. Med Princ Pract. 28(5):457-62, 2019
- Bolarinwa SA et al: Reducing costly falls after total knee arthroplasty. World J Orthop. 9(10):198-202, 2018
- Büttner B et al: Paths of femoral nerve catheters placed using ultrasound-guided in plane vs out of plane techniques: a randomized controlled clinical trial. Medicine (Baltimore). 97(43):e12958, 2018
- Fenten MGE et al: Femoral nerve catheter vs local infiltration for analgesia in fast track total knee arthroplasty: short-term and long-term outcomes. Br J Anaesth. 121(4):850-8, 2018
- Talmo CT et al: Prospective randomized trial comparing femoral nerve block with intraoperative local anesthetic injection of liposomal bupivacaine in total knee arthroplasty. J Arthroplasty. 33(11):3474-8, 2018
- Zhang X et al: Efficacy and safety of lower extremity nerve blocks for postoperative analgesia at free fibular flap donor sites. Head Neck. 40(12):2670-6, 2018
- Paul JE et al: Femoral nerve block improves analgesia outcomes after total knee arthroplasty: a meta-analysis of randomized controlled trials. Anesthesiology. 113(5):1144-62, 2010
- Kandasami M et al: Femoral nerve block for total knee replacement - a word of caution. Knee. 16(2):98-100, 2009
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Abbreviations
- Femoral nerve (FN)
- Femoral vein (FV)
- Femoral nerve block (FNB)
- Saphenous nerve (SN)
Definitions
- FN: Largest branch of lumbar plexus and is derived from anterior rami of L2, L3, L4
- FN is motor and sensory nerve
- Motor: Contributes to hip flexion by innervating pectineus, iliacus, sartorius muscles; responsible for knee extension by innervating vastus medialis, vastus lateralis, vastus intermedius
- Sensory: Anterior cutaneous branches of FN (sensory to anteromedial thigh) and terminal cutaneous branch of FN is SN (sensory to medial leg and foot)
- FN osteotome
- FN and its distal branch is responsible for sensory innervation (osteotome) of medial and anterior distal portion of femur
- In addition, FN provides sensation to anteromedial tibia and medial malleolus
- FNB can be performed by landmark technique with nerve stimulator or ultrasound-guided technique after FN courses underneath inguinal ligament to enter femoral triangle
- Femoral triangle borders
- Superior (base): Inguinal ligament
- Lateral: Sartorius muscle (medial margin)
- Medial: Adductor longus muscle (lateral margin)
- Apex: Sartorius muscle and adductor magnus muscle
- Floor: Iliopsoas, pectineus, adductor longus muscle
- Anterior: Fascia iliaca
- FNB (combined with sciatic nerve block) can provide complete anesthesia and analgesia for procedures of ipsilateral lower extremity
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
- Angers M et al: Negative influence of femoral nerve block on quadriceps strength recovery following total knee replacement: a prospective randomized trial. Orthop Traumatol Surg Res. 105(4):633-7, 2019
- Dimaculangan D et al: Periarticular injection and continuous femoral nerve block versus continuous femoral nerve block alone on postoperative opioid consumption and pain control following total knee arthroplasty: Randomized controlled trial. J Clin Orthop Trauma. 10(1):81-6, 2019
- Li J et al: A practical analgesia approach to fragility hip fracture: a single-center, retrospective, cohort study on femoral nerve block. J Orthop Trauma. 33(4):175-9, 2019
- Lynch JR et al: Adductor canal block versus femoral nerve block for pain control after anterior cruciate ligament reconstruction: a prospective randomized trial. Am J Sports Med. 47(2):355-63, 2019
- Ohgoshi Y et al: Use of IPACK block with continuous femoral triangle block for total knee arthroplasty: a clinical experience. J Clin Anesth. 54:52-4, 2019
- Zhao XY et al: Ultrasound-guided continuous femoral nerve block with dexmedetomidine combined with low concentrations of ropivacaine for postoperative analgesia in elderly knee arthroplasty. Med Princ Pract. 28(5):457-62, 2019
- Bolarinwa SA et al: Reducing costly falls after total knee arthroplasty. World J Orthop. 9(10):198-202, 2018
- Büttner B et al: Paths of femoral nerve catheters placed using ultrasound-guided in plane vs out of plane techniques: a randomized controlled clinical trial. Medicine (Baltimore). 97(43):e12958, 2018
- Fenten MGE et al: Femoral nerve catheter vs local infiltration for analgesia in fast track total knee arthroplasty: short-term and long-term outcomes. Br J Anaesth. 121(4):850-8, 2018
- Talmo CT et al: Prospective randomized trial comparing femoral nerve block with intraoperative local anesthetic injection of liposomal bupivacaine in total knee arthroplasty. J Arthroplasty. 33(11):3474-8, 2018
- Zhang X et al: Efficacy and safety of lower extremity nerve blocks for postoperative analgesia at free fibular flap donor sites. Head Neck. 40(12):2670-6, 2018
- Paul JE et al: Femoral nerve block improves analgesia outcomes after total knee arthroplasty: a meta-analysis of randomized controlled trials. Anesthesiology. 113(5):1144-62, 2010
- Kandasami M et al: Femoral nerve block for total knee replacement - a word of caution. Knee. 16(2):98-100, 2009
