Anatomical Landmarks for Femoral Nerve Block: A Comparison of Four Needle Insertion Sites

Vloka, Jerry D.; Hadžić, Admir; Drobnik, Leon; Ernest, April; Reiss, Wojciech; Thys, Daniel M.

doi:10.1213/00000539-199912000-00028

Cited by 69 publications

(28 citation statements)

References 5 publications

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“…Commonly, the anterior branch of the femoral nerve will be identified first. Vloka et al 40 reported this to be the first motor response elicited 97% of the time. Stimulation of this branch leads to contraction of the sartorius muscle on the medial aspect of the thigh and should not be accepted, as the articular and muscular branches derive from the posterior branch of the femoral nerve.…”

Section: Approaches To the Lower Extremitymentioning

confidence: 90%

Lower-extremity peripheral nerve blockade: Essentials of our current understanding

Enneking

Chan

Greger³

et al. 2005

Regional Anesthesia and Pain Medicine

102

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Section: Approaches To the Lower Extremitymentioning

confidence: 90%

Lower-extremity peripheral nerve blockade: Essentials of our current understanding

Enneking

Chan

Greger³

et al. 2005

Regional Anesthesia and Pain Medicine

102

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“…Com a técnica da perda de resistência nos pacientes anestesiados ou sedados, isto não ocorre, embora haja o temor de injeção intraneural. Como o acesso ao espaço perifemoral oferece múltipla escolha de penetração, quer no sentido craneal ou caudal 20 , a fibrose cicatricial resultante de cateter de demora nesse espaço, em analgesia prolongada, e de um modo geral, a fibrose por punções prévias oriunda de bloqueios repetitivos, não oferece dificuldade com a técnica utilizada no grupo A. Em conclusão, embora o ENP não seja imprescindível na grande maioria dos bloqueios nervosos periféricos, mormente em regiões onde o contingente neural se encontra em espaços ou em planos de clivagem virtuais, outras técnicas podem ser selecionadas. Semelhante à identificação do espaço peridural pela técnica de Pagés, uma pressão intermitente ou contínua sobre o êmbolo da seringa nos permite distinguir alterações de densidade tecidual, à medida que a agulha avança.…”

Section: Discussionunclassified

“…With the loss of resistance technique, this does not occur in anesthetized or sedated patients, although the concern with intraneural injection shall persist. Since the perifemoral space offers several access options, both in the cephalad and caudal direction 20 , fibrosis resulting from resident catheters in this space for prolonged anesthesia and, in general, fibrosis due to previous punctures for repetitive blocks, did not present any difficulties with the technique used in group A.…”

mentioning

confidence: 97%

É realmente necessário o uso do estimulador de nervo periférico no bloqueio do nervo femoral?

Geier¹

2003

Rev. Bras. Anestesiol.

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“…Although cadaveric studies seem to suggest that the nerve is easier to locate at the crease, these two landmarks have not been compared with RCTs in humans. 28 During electrolocation of the femoral nerve, two responses are often encountered: sartorius muscle contraction (stimulation of the anterior branch of the femoral nerve) and quadriceps muscle contraction or "dancing patella" sign (stimulation of the posterior branch of the femoral nerve). Most authors advocate preferentially searching for the latter response as articular branches derive from the posterior branch.…”

Section: Femoral Nerve Blockmentioning

confidence: 99%

A review of approaches and techniques for lower extremity nerve blocks

Tran

Clemente

Finlayson

2007

Can J Anesth/J Can Anesth

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Purpose: The purpose of this narrative review is to summarize the evidence derived from randomized controlled trials (RCTs) regarding approaches and techniques for lower extremity nerve blocks.Source: Using the MEDLINE (January 1966 to April 2007 and EMBASE (January 1980 to April 2007 databases, medical subject heading (MeSH) terms "lumbosacral plexus", "femoral nerve", "obturator nerve", "saphenous nerve", "sciatic nerve", "peroneal nerve" and "tibial nerve" were searched and combined with the MESH term "nerve block" using the operator "and". Keywords "lumbar plexus", "psoas compartment", "psoas sheath", "sacral plexus", "fascia iliaca", "three-in-one", "3-in-1", "lateral femoral cutaneous", "posterior femoral cutaneous", "ankle" and "ankle block" were also queried and combined with the MESH term "nerve block". The search was limited to RCTs involving human subjects and published in the English language. Forty-six RCTs were identified. Principal findings:Compared to its anterior counterpart (3-in-1 block), the posterior approach to the lumbar plexus is more reliable when anesthesia of the obturator nerve is required. The fascia iliaca compartment block may also represent a better alternative than the 3-in-1 block because of improved efficacy and efficiency (quicker performance time, lower cost). For blockade of the sciatic nerve, the classic transgluteal approach constitutes a reliable method. Due to a potentially shorter time for sciatic nerve electrolocation and catheter placement than for the transgluteal approach, the subgluteal approach should also be considered. Compared to electrolocation of the peroneal nerve, electrostimulation of the tibial nerve may offer a higher success rate especially with the transgluteal and lateral popliteal approaches. Furthermore, when performing sciatic and femoral blocks with low volumes of local anesthetics, a multiple-injection technique should be used. MeSH « nerve block » à l'aide de l'opérateur « and ». Les mots clés « lumbar plexus », « psoas compartment », « psoas sheath », « sacral plexus », « fascia iliaca », « lateral Conclusions Objectif : L'objectif de cet examen narratif est de résumer les données probantes dérivées d'études randomisées contrôlées (ERC) concernant les approches et techniques pour les blocs nerveux du membre inférieur. Source : A l'aide des bases de données MEDLINE (janvier 1966 à avril 2007) et EMBASE (janvier 1980 à avril 2007), les termes MeSH (vedette-matière médicale) « lumbosacral plexus », « femoral nerve », « obturator nerve », « saphenous nerve », « sciatic nerve », « peroneal nerve » et « tibial nerve » ont été recherchés et combinés au terme

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Anatomical Landmarks for Femoral Nerve Block: A Comparison of Four Needle Insertion Sites

Cited by 69 publications

References 5 publications

Lower-extremity peripheral nerve blockade: Essentials of our current understanding

Lower-extremity peripheral nerve blockade: Essentials of our current understanding

É realmente necessário o uso do estimulador de nervo periférico no bloqueio do nervo femoral?

A review of approaches and techniques for lower extremity nerve blocks

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