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
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
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Related Differential Diagnoses
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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
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
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