The posterior division of the L2 and L3 nerves forms the lateral cutaneous nerve that passes below the ilioinguinal nerve at the anterior superior iliac spine and then passes below the inguinal ligament. The lateral cutaneous nerve then divides into the anterior branch that supplies sensory innervation over the anterolateral thigh and the posterior branch that supplies sensory innervation to the lateral thigh from the knee to just above the greater trochanter.
Arrange sterile towels, sterile gloves, gauze pads, marking pen, antiseptic solution, syringes, and needles for local infiltration and nerve block placement.
10 ml syringes of local anesthetic. Needles
25 g 1.5 in. needle for skin infiltration.
3% chloroprocaine, 2% lidocaine, 0.5% ropivacaine, 0.5% bupivacaine.
Landmarks include femoral crease, inguinal ligament, and anterior superior iliac spine. With the patient in the supine position, the anterior superior iliac spine is identified by palpation. Under an aseptic technique, 25 g 1.5 in. needle is advanced at a point 1 in. medial to the anterior superior iliac spine and just below the inguinal ligament. As the needle passes through the fascia, a pop can often be felt. After negative aspiration a total of 5-7 cc of local is injected in a fan-like fashion.
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