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Femoral nerve blocks

Femoral nerve blocks:

• Identify inguinal ligament or leg crease
• Draw a line over the femoral artery
• Remember NAVEL – nerve, artery, vein, empty space, lymphatics (lateral to medial)
• Make a mark 1 cm lateral to the artery and 1 cm below crease
• Raise a skin wheal with local
• Go straight down with Stimuplex needle
• Sartorius (medial) twitch? Go lateral, cephalad, and a little deeper
• Still sartorius? Reintroduce the needle further lateral and repeat steps
• Hold minimal pressure on the skin
• Kuhia puts his middle finger over the femoral artery, with his hand laying parallel to the leg. For the right femoral nerve, he puts the needle right over his ring finger. .  For the left femoral nerve, he shoots right over his index finger. If he gets sartorius, he goes further lateral.

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