Ultrasound-guided three-in-one nerve block for femur fractures

Steve C Christos, George Chiampas, Ryan Offman, Robert Rifenburg, Steve C Christos, George Chiampas, Ryan Offman, Robert Rifenburg

Abstract

Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular and respiratory complications from opiate administration. Ultrasound (US)-guided three-in-one (3-in-1) femoral nerve block (FNB) is an option for pain management in patients with femur fractures, as it provides regional anesthesia to the femoral, obturator and lateral cutaneous nerves. Our goal is to provide medical education regarding the use of US-guided 3-in-1FNB as a rapid and easy procedure that may provide optimal patient care in patients with femur fractures.

Figures

Figure 1.
Figure 1.
Ultrasound probe on right side of patient’s groin
Figure 2.
Figure 2.
Inguinal ligament (IL).
Figure 3a
Figure 3a
Ultrasound image of femoral vein (FV), artery (FA), nerve (FN) and inguinal ligament (IL).
Figure 3b
Figure 3b
Ultrasound image of femoral vein (FV), artery (FA), and nerve (FN) with color flow doppler.
Figure 4.
Figure 4.
Lateral approach of 21 gauge spinal needle with 20 ml of bupivacaine 0.5% on patient’s right side.
Figure 5.
Figure 5.
Ultrasound image of femoral vein (FV), artery (FA), nerve (FN) and inguinal ligament (IL) and expanding bupivacaine around FN.

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Source: PubMed

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