Supra-inguinal injection for fascia iliaca compartment block results in more consistent spread towards the lumbar plexus than an infra-inguinal injection: a volunteer study

Regional Anesthesia and Pain Medicine
Kris VermeylenMarc Van de Velde

Abstract

Lumbar plexus block has been used to provide postoperative analgesia after lower limb surgery. The fascia iliaca compartment block (FICB) has been proposed as an anterior approach of the lumbar plexus targeting the femoral, obturator and lateral femoral cutaneous nerve. However, both radiological and clinical evidence demonstrated that an infra-inguinal approach to the fascia iliaca compartment does not reliably block the three target nerves.We hypothesized that a supra-inguinal approach of the fascia iliaca compartment results in a more consistent block of the three target nerves than an infra-inguinal approach. We performed a randomized controlled, double-blind trial in 10 healthy volunteers. Both an infra-inguinal FICB (I-FICB) and a supra-inguinal FICB (S-FICB) were performed on the left or the right side in each volunteer. Forty milliliters of lidocaine 0.5% was injected with each approach. Sensory and motor block and spread of local anesthetics (LA) on MRI were assessed. After an S-FICB, 80% of the volunteers had a complete sensory block of the medial, anterior and lateral region of the thigh, compared with 30% after an I-FICB (p=0.035). There was an insignificant effect on motor function with both approaches. After an S-...Continue Reading

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Citations

Jul 26, 2019·Current Opinion in Anaesthesiology·Maria Fernanda ArboledaPhilip W H Peng
Mar 11, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ana SchwartzmannMauricio Forero
Aug 4, 2019·Regional Anesthesia and Pain Medicine·Thomas Fichtner BendtsenPhilip Peng
Mar 12, 2021·Current Pain and Headache Reports·Thomas VerbeekHenry Liu
Apr 30, 2021·Regional Anesthesia and Pain Medicine·Thomas Fichtner BendtsenPhilip Peng
Apr 30, 2021·Regional Anesthesia and Pain Medicine·Thomas Fichtner BendtsenPhilip Peng
Apr 30, 2021·Regional Anesthesia and Pain Medicine·De Q TranPrangmalee Leurcharusmee
Jun 20, 2021·Regional Anesthesia and Pain Medicine·David H KimStavros G Memtsoudis
Jul 30, 2021·Current Opinion in Anaesthesiology·Levin GaripSam Van Boxstael
Dec 22, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Carlos Rodrigues Almeida, Lígia Vieira

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