Figure 21.9c Ultrasound image of a femoral block. Note the spread of local anesthetic (hypoechoic) around the femoral nerve. FA femoral artery, LA local anesthetic, MED medial, LAT lateral, arrows identify the block needle.


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Figure 21.9d Ultrasound of the femoral nerve and surrounding structures. Note the mixed natured appearance (white-gray-black) of the nerve just lateral to the femoral artery. FA femoral artery, FN femoral nerve, ISM iliopsoas muscle, LAT lateral, MED medial.

is pierced, the femoral nerve block can be performed with typically 20 ml of local anesthetic. There is little information about the optimal volume of local anesthetic for ultrasound-guided femoral nerve block although it is possible in the future that the volume required for adequate block will decrease. Higher volumes (>20 ml) are likely required to ensure blockade of the lateral femoral cutaneous nerve of the thigh and the anterior branch of the obturator nerve via proximal spread of the local anesthetic.

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