《LANDMARK AND ULTRASOUND APPROACH(ANAESTHESIA TUTORIAL OF THE WEEK)》.pdf

Fascia Iliaca Compartment Block: LANDMARK AND ULTRASOUND APPROACH ANAESTHESIA TUTORIAL OF THE WEEK 193 23rd AUGUST 2010 Dr Christine Range, Specialist Registrar Anaesthesia Dr Christian Egeler, Consultant Anaesthetist Morriston Hospital, Swansea Correspondence - C Range: range.christine@yahoo.co.u QUESTIONS 1. Please answer true or false: Anatomy relevant to the Fascia Iliaca Compartment Block: a. The lateral femoral cutaneous nerve originates from the spinal roots L2, L3 and L4. b. The femoral nerve gives motor supply to the knee flexors. c. Most of the lower leg receives sensory supply from the sciatic nerve. d. Behind the inguinal ligament, the femoral nerve, artery and vein all lie within one sheath. e. The fascia iliaca covers three of the four main nerves of the lower extremity. 2. Please answer true or false: The following are indications for the Fascia Iliaca Compartment Block: a. Analgesia for ankle surgery b. Pre- and post-operative analgesia for patients with fractured neck of femur. c. As sole anaesthetic for above knee amputation. d. In anticoagulated patients, in whom neuraxial blockade is contra-indicated. e. The intention to paralyse the hip adductor muscles, e.g. for TURBT. 3. Please answer true or false: With regards to techniques of Fascia Iliaca Compartment Block: a. The landmark technique is considered to be safer than a direct femoral nerve block, be- cause it keeps a greater distance to the femoral nerve and vessels. b. The bony landmarks used are the anterior superior iliac spine and the pubic symphysis. c. As the injection is away from nerves and vessels, sharp needles are ideal for this block. d. For the ultrasound technique, a high frequency ultrasound probe (13-6 M