Lateral Femoral Cutaneous Nerve Injection

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Lateral Femoral Cutaneous Nerve Injection
Indication
Syringe	5-10mL
Needle	22-gauge 4cm

The lateral femoral cutaneous nerve (LFCN) of the thigh.

Technique

Landmark Guided

The traditional technique is a fanned-out injection through the fascia lata along the inguinal ligament without eliciting paraesthesia. The fascia iliaca block is elegant in its solution to addressing the anatomical variability of the LFCN. The landmark guidance has several disadvantages to ultrasound guided injection. Failure rates have been reported up to 60%, and slow onset can occur. There have been reports of inadvertent blockage of all three of the obturator, femoral, and LFC nerves. There is also the risk for needle trauma to the LFCN.

• Identify 2-3cm inferior to and 2-3cm medial to the ASIS.
• Inject local anaesthetic under the skin making a wheal.
• Insert a short bevel 22-gauge 4cm needle perpendicularly.
• Advance until a "pop" occurs. This signifies passage through the fascia lata.
• Aspirate confirming no blood.
• Inject 2/3 of the injectate.
• Withdraw slightly above the fascia lata.
• Inject the last 1/3 of the injectate in a fan medially and laterally.

Examine for evidence of femoral and obturator nerve blockage prior to release.

Literature Review

Literature Review

Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf

Articles from all years: PubMed search, Google Scholar search.

TRIP Database: clinical publications about evidence-based medicine.

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