Indication
Anesthesia of the ipsilateral hindlimb distal to the mid femur. Suitable for example for knee surgery (TPLO, TTA), stifle arthroscopy and surgery of the tarsus (in combination with sciatic and obturator nerve)
Step by step
Local anesthetics
Femoral nerve block (Nerve stimulation)
(Campoy 2006)
Local anesthetics: Lidocain 2%, Mepivacain 2%, Bupivacain 0.5%, Ropivacain 0.75%
Initial setting NS: 0.5-1.0 mA, 2 Hz, 0.10 ms
Needle orientation: needle insertion cranial to the femoral artery in a dorso-cranial direction, insertion angle 20-30°
Muscle contraction: knee extension
Reduction of the amperage: in small increments to <0.5 mA
Correction of the needle position: minor corrections only, pull back needle, correct angle, re-advance needle
MSC control: to avoid block failure
Aspiration and injection: slowly, Raj test, BSmart
Injection volume: 0.1 ml/kg
(Costa-Farre et al. 2011, Campoy et al.2010)
Femoral nerve block (Nerve stimulation)
(Campoy et al. 2010)
Local anesthetics: Lidocain 2%, Mepivacain 2%, Bupivacain 0.5%, Ropivacain 0.75%
Initial setting NS: 0.5-1.0 mA, 2 Hz, 0.10 ms
Needle orientation alternative: needle insertion in a caudal direction through the quadriceps muscle
Muscle contraction: knee extension
Reduction of the amperage: in small increments to <0.5 mA
Correction of the needle position: minor corrections only, pull back needle, correct angle, re-advance needle
MSC control: to avoid block failure
Aspiration and injection: slowly, Raj test, BSmart
Injection volume: 0.1 ml/kg
Videos
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Femoral nerve block (Nerve stimulation)
Incorrect muscle response (M. iliopsoas)
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Femoral nerve block (Nerve stimulation)
Correct muscle response (Quadriceps muscle)
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Femoral nerve block (Nerve stimulation/US)
Correct muscle response (Quadriceps muscle)
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Femoral nerve block (Nerve stimulation/US)
AF = Femoral artery; arrow points to the femoral nerve
Disclaimer
As with any intervention in the body, peripheral nerve blocks also carry the risk of complications. The presented procedures and dosages are thoroughly reviewed and based on currently available scientific data and clinical experience but should only be considered as guidelines along the contents of the course. The responsibility for performing the nerve blocks shown on this site as part of any anesthesia regimen or pain management lies with the executing clinician. B. Braun Vet Care GmbH and Dr. Papadopoulos cannot be held responsible for any complications or adverse effects, that may arise from the described techniques or for any mistakes in the information provided.