Fascia Iliaca Block

Ideal block for perioperative analgesia for THR or #NOF surgery. Can be performed either as a single shot or with a catheter

Category:

Howto & Style

Tags:

• Fascia
• Iliaca
• Regional
• Local
• Anaesthesia
• Anesthesia
• Analgesia
• Hip
• Surgery
• Fracture
• Perioperative

[schaferhund8]

thanks for the reply, do you use a concoction of a mixture of bupivacaine and xylocaine and how much of each do you use in what concentration. I was told by my boss to watch your video as he reckons it's great for fractured NOFs and femurs.

[driharper]

No need to use Xylocaine (lidocaine) - the block has an incredibly fast onset using bupivacaine only. I suspect this is due to the LA penetrating the ilio-psoas muscle causing an immediate reduction in the fracture associated spasm.

[schaferhund8]

yeah indeed, that stridor just sound like a happy sound. I wish there was some commentary taking us through the procedure. Why is it better that the usual femoral nerve block?

[driharper]

The block is performed more laterally to the traditional approach to the femoral nerve. Therefore, using a volume of LA of 20mls+ you should also achieve a lateral cutaneous nerve of thigh block. This may be useful for THR or #NOF surgery. Also, the block is performed without the aid of a nerve stimulator and so can easily be taught to non-anaesthetists (and even non-doctors). This may allow the block to applied to patients in a non-OR environment e.g. A&E or the wards.

[yidakishaman]

Great video, thanks, I've already tried for OR. I'll give it a go for #NOF in ER next.

Any chance you can add text or audio commentary?

[jondg1]

non-sense, he/she was just snoring......zzzz

not a bad thing if you/ve got a hip fracture

[ahnguard88]

Excellent video. The two "pops" illustrated in the beginning are the key teaching points here. May I suggest an audio teaching "commentary" that can be added in post-production? Keep up the great work!

[minihada]

Excellent video ! I use this block a lot in my practice but more as a sigle shot. How much do you advance the catheter usually ? In your experience how many days do they "endure" before dislodging ? What rate of infusion do you prescribe for the postoperatory period ? Thanks again for an excellent video

[portbair]

I wish the demonstrator had tried to explain the procedure to mask the patient's obstructed airway. I wish the patient all the best for his recovery

[drgreenway]

Good technique for fascia iliaca block. That guy needed his obstructed airway sorting out though!