Nerve Block Gallery - Fascia Iliaca Compartment Block
Caption
A 60s M presented with hip pain after a fall while skiing. He had a visible closed leg deformity but was neurovascularly intact. Radiographs confirmed a femoral neck fracture. A fascia iliaca compartment block was performed for analgesia and to facilitate orthopedic evaluation. The first part of this clip shows the anatomy of the fascia iliaca, with the femoral artery (A), femoral vein (V), and femoral nerve (*) superficial and medial to the iliacus muscle (I). The fascia iliaca (^) overlies the iliacus muscle. The later portion of the clip shows a fascia iliaca compartment block performed by inserting a needle from the lateral aspect until the tip is just deep to the fascia iliaca, and instilling a large amount (30-40cc) of anechoic local anesthetic in the fascial plane just superficial to the iliacus muscle (I). The injection of anesthetic in this fascial plane allows the anesthetic to spread over a larger anatomic area, providing anesthesia to the lateral femoral cutaneous nerve and obturator nerve in addition to the femoral nerve. Dr. Larry Benjey, PGY3 Denver Health Residency in Emergency Medicine