10 – How to perform a femoral nerve block

– Place a linear high-frequency probe in the inguinal groove and identify the pulsatile femoral artery
– Align the artery to the centre of the monitor by adjusting the position of the probe and the depth of the image
– Locate the femoral nerve (FN) lateral to the artery on top of the iliac muscle. The FN is usually flattened, spindle-shaped or triangular – rarely round
– Capture the best possible cross-sectional image of the FN by tilting the probe 10-30 degrees cranially
– Insert the needle from the lateral end of the probe
– Advance the needle inside the plane of the ultrasound beam (in-plane, IP) until the tip of the needle touches the deep surface of the FN tangentially
– The endpoint is complete perineural spread of local anaesthetic