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Lateral Femoral Cutaneous Nerve Block
Kimberly Ting, MD; Rafael Vazquez, MD; Nicole Z. Spence, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Abbreviations

              • Lateral femoral cutaneous nerve (LFCN)
              • Inguinal ligament (IL)
            • Definitions

              • LFCN arises from posterior divisions of ventral rami of L2 and L3
                • Purely sensory providing sensation to lateral thigh
                • Emerges from lateral border of psoas major muscle over iliacus and under fascia iliaca
                • Travels caudal across iliacus toward anterior superior iliac spine (ASIS) and deep to IL (70% to 90%)
                • In thigh, located ventral and lateral to sartorius muscle and dorsal to fascia iliaca
                  • More caudal, nerve lies in LFCN canal comprised of double layer of fascia lata between sartorius and tensor fascia lata muscles
                    • LFCN canal is a.k.a. fat-filled flat tunnel (FFFT)

            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. Ueshima H et al: Blocking the femoral and lateral femoral cutaneous nerves using an iliac muscle plane block. J Clin Anesth. 53:2-3, 2019
                                        2. Coraci D et al: The lateral femoral cutaneous nerve: ultrasound support in nerve assessing. Reg Anesth Pain Med. 43(6):650-1, 2018
                                        3. Kokubo R et al: Anatomic variation in patient with lateral femoral cutaneous nerve entrapment neuropathy. World Neurosurg. 115:274-6, 2018
                                        4. Nersesjan M et al: Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial. Acta Anaesthesiol Scand. 62(6):863-73, 2018
                                        5. Nielsen TD et al: The lateral femoral cutaneous nerve: description of the sensory territory and a novel ultrasound-guided nerve block technique. Reg Anesth Pain Med. 43(4):357-66, 2018
                                        6. Gupta G et al: A randomized comparison between neurostimulation and ultrasound-guided lateral femoral cutaneous nerve block. US Army Med Dep J. 33-8, 2017
                                        7. Hanna A: The lateral femoral cutaneous nerve canal. J Neurosurg. 126(3):972-8, 2017
                                        8. Palamar D et al: Ultrasound-guided diagnosis and injection of the lateral femoral cutaneous nerve with an anatomical variation. Pain Pract. 17(8):1105-8, 2017
                                        9. Ahmed A et al: Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series. Br J Pain. 10(4):232-7, 2016
                                        10. Coraci D et al: Ultrasound in anatomical variation of lateral femoral cutaneous nerve. Pain Physician. 19(7):E1097-8, 2016
                                        11. Thybo KH et al: Lateral femoral cutaneous nerve block after total hip arthroplasty: a randomised trial. Acta Anaesthesiol Scand. 60(9):1297-305, 2016
                                        12. Menzer C et al: Discriminative sensory characteristics of the lateral femoral cutaneous nerve after mepivacaine-induced block. Scand J Pain. 4(2):95-100, 2013
                                        13. Shteynberg A et al: Ultrasound guided lateral femoral cutaneous nerve (LFCN) block: safe and simple anesthesia for harvesting skin grafts. Burns. 39(1):146-9, 2013
                                        14. Ray B et al: Variations in the course and microanatomical study of the lateral femoral cutaneous nerve and its clinical importance. Clin Anat. 23(8):978-84, 2010
                                        15. Sim IW et al: Anatomy and anaesthesia of the lumbar somatic plexus. Anaesth Intensive Care. 32(2):178-87, 2004
                                        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

                                                    • Lateral femoral cutaneous nerve (LFCN)
                                                    • Inguinal ligament (IL)
                                                  • Definitions

                                                    • LFCN arises from posterior divisions of ventral rami of L2 and L3
                                                      • Purely sensory providing sensation to lateral thigh
                                                      • Emerges from lateral border of psoas major muscle over iliacus and under fascia iliaca
                                                      • Travels caudal across iliacus toward anterior superior iliac spine (ASIS) and deep to IL (70% to 90%)
                                                      • In thigh, located ventral and lateral to sartorius muscle and dorsal to fascia iliaca
                                                        • More caudal, nerve lies in LFCN canal comprised of double layer of fascia lata between sartorius and tensor fascia lata muscles
                                                          • LFCN canal is a.k.a. fat-filled flat tunnel (FFFT)

                                                  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. Ueshima H et al: Blocking the femoral and lateral femoral cutaneous nerves using an iliac muscle plane block. J Clin Anesth. 53:2-3, 2019
                                                                              2. Coraci D et al: The lateral femoral cutaneous nerve: ultrasound support in nerve assessing. Reg Anesth Pain Med. 43(6):650-1, 2018
                                                                              3. Kokubo R et al: Anatomic variation in patient with lateral femoral cutaneous nerve entrapment neuropathy. World Neurosurg. 115:274-6, 2018
                                                                              4. Nersesjan M et al: Sensory distribution of the lateral femoral cutaneous nerve block - a randomised, blinded trial. Acta Anaesthesiol Scand. 62(6):863-73, 2018
                                                                              5. Nielsen TD et al: The lateral femoral cutaneous nerve: description of the sensory territory and a novel ultrasound-guided nerve block technique. Reg Anesth Pain Med. 43(4):357-66, 2018
                                                                              6. Gupta G et al: A randomized comparison between neurostimulation and ultrasound-guided lateral femoral cutaneous nerve block. US Army Med Dep J. 33-8, 2017
                                                                              7. Hanna A: The lateral femoral cutaneous nerve canal. J Neurosurg. 126(3):972-8, 2017
                                                                              8. Palamar D et al: Ultrasound-guided diagnosis and injection of the lateral femoral cutaneous nerve with an anatomical variation. Pain Pract. 17(8):1105-8, 2017
                                                                              9. Ahmed A et al: Ultrasound-guided alcohol neurolysis of lateral femoral cutaneous nerve for intractable meralgia paresthetica: a case series. Br J Pain. 10(4):232-7, 2016
                                                                              10. Coraci D et al: Ultrasound in anatomical variation of lateral femoral cutaneous nerve. Pain Physician. 19(7):E1097-8, 2016
                                                                              11. Thybo KH et al: Lateral femoral cutaneous nerve block after total hip arthroplasty: a randomised trial. Acta Anaesthesiol Scand. 60(9):1297-305, 2016
                                                                              12. Menzer C et al: Discriminative sensory characteristics of the lateral femoral cutaneous nerve after mepivacaine-induced block. Scand J Pain. 4(2):95-100, 2013
                                                                              13. Shteynberg A et al: Ultrasound guided lateral femoral cutaneous nerve (LFCN) block: safe and simple anesthesia for harvesting skin grafts. Burns. 39(1):146-9, 2013
                                                                              14. Ray B et al: Variations in the course and microanatomical study of the lateral femoral cutaneous nerve and its clinical importance. Clin Anat. 23(8):978-84, 2010
                                                                              15. Sim IW et al: Anatomy and anaesthesia of the lumbar somatic plexus. Anaesth Intensive Care. 32(2):178-87, 2004