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THE LATERAL FEMORAL CUTANEOUS NERVE - DESCRIPTION OF THE SENSORY TERRITORY AND A NOVEL ULTRASOUND GUIDED NERVE BLOCK TECHNIQUE
Author(s): ,
Nielsen, T.D.*
Affiliations:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Aarhus, Denmark
,
Moriggl, B.
Affiliations:
Medical University of Innsbruck, Department of Anatomy- Histology and Embryology, Innsbruck, Austria
,
Barckman, J.
Affiliations:
Aarhus University Hospital, Department of Orthopaedic Surgery, Aarhus, Denmark
,
Kølsen-Petersen, J.A.
Affiliations:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Aarhus, Denmark
,
Søballe, K.
Affiliations:
Aarhus University Hospital, Department of Orthopaedic Surgery, Aarhus, Denmark
,
Neimann, J.B.
Affiliations:
Zealand University Hospital, Department of Anaesthesiology and Intensive Care, Roskilde, Denmark
Bendtsen, T.F.
Affiliations:
Aarhus University Hospital, Department of Anaesthesiology and Intensive Care, Aarhus, Denmark
ESRA Academy. Nielsen T. Sep 13, 2017; 190932; 394
Thomas Dahl Nielsen
Thomas Dahl Nielsen

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Abstract
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Background and Aims:

Proximal branches of the lateral femoral cutaneous (LFC) nerve innervate incisional areas in relation to hip surgery. Ultrasound guided (USG) LFC nerve block techniques are based on either compartmental spread deep to the iliac fascia or alternatively by selectively targeting the LFC nerve on the anterior surface of the sartorius muscle. The former technique causes concomitant femoral motor paralysis and the latter is technically challenging and reduces success rate. Distal to the inguinal ligament, the LFC nerve runs in a fat-filled fascial canal (FFC) between the sartorius and tensor fascia lata muscles. Our aim is to investigate the effect and feasibility of a novel USG nerve block technique injecting into the FFC.

Methods:

Twenty healthy volunteers were included in a triple-blind randomized trial conducted over two consecutive days. On day one, all subjects received a supra inguinal fascia iliaca compartment (SI-FIC) block bilaterally. The anaesthetised area was assessed and marked with an ultraviolet marker. On day two, all subjects received a novel USG LFC nerve block injecting into the FFC. Local anaesthetic and placebo was randomised between sides in each subject. The primary endpoint was successful anaesthesia of the skin innervated by the proximal LFC branches, defined by the anesthetised area of the SI-FIC block.

Results:

Anaesthesia of the lateral thigh was successful in 94.7% with active block and in 0% with placebo, p<0.001. Mean block procedure time was 3.4 minutes. The proximal branches were anaesthetised in 68.4%, p<0.001.

Conclusions:

USG LFC nerve block in the FFC is a quick and feasible technique.

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