By turning USG probe in plane, you inject the local in femoral nerve sheath or fascia illiaca plane? If it's in femoral nerve sheath will it spread to lateral femoral cutaneous nerve of thigh and obturator? Please specify. Thank you sir. I just love your videos and practical tips.
There is no distinct femoral nerve sheath. The femoral nerve is encased by a splitting of the fascia iliaca. By targeting the lateral aspect of the nerve, you are entering deep to fascia iliaca and opening up the plane. As you can see when you turn probe longitudinal and get a parasagittal view, you can see that the local anesthetic is forming a layer over the iliopsoas muscle and spreading into the pelvis (2:45 in the video). To consistently get the LFCN, the LA has to spread high and lateral enough - this means using volumes of 30-40ml (see pubmed.ncbi.nlm.nih.gov/30798268/), and perhaps also injecting with more pressure on the syringe. But for sure you have a better chance than if you do an infrainguinal IP approach to either fascia iliaca or femoral nerve.
Thank you for the kind comment - as always, I am just happy for the opportunity to share what I find useful in my own practice.
In contrast with other famous experts in this field your unselfishness is remarkable! Thank you so much !!!!
Thank you for the kind comment - as always, I am just happy for the opportunity to share what I find useful in my own practice.
Excellent way. Thank you.
By turning USG probe in plane, you inject the local in femoral nerve sheath or fascia illiaca plane?
If it's in femoral nerve sheath will it spread to lateral femoral cutaneous nerve of thigh and obturator? Please specify.
Thank you sir.
I just love your videos and practical tips.
There is no distinct femoral nerve sheath. The femoral nerve is encased by a splitting of the fascia iliaca. By targeting the lateral aspect of the nerve, you are entering deep to fascia iliaca and opening up the plane. As you can see when you turn probe longitudinal and get a parasagittal view, you can see that the local anesthetic is forming a layer over the iliopsoas muscle and spreading into the pelvis (2:45 in the video). To consistently get the LFCN, the LA has to spread high and lateral enough - this means using volumes of 30-40ml (see pubmed.ncbi.nlm.nih.gov/30798268/), and perhaps also injecting with more pressure on the syringe. But for sure you have a better chance than if you do an infrainguinal IP approach to either fascia iliaca or femoral nerve.
@@KiJinnChin Thanks a lot sir for that detailed reply.