39 Fascia Iliaca Block
Suggested Technique
The patient is placed in supine position (flat with slight extension of the hip). Pannus retraction or reverse Trendelenburg position may be necessary in overweight patients. Place the transducer longitudinally to image the iliacus muscle lateral to the femoral nerve. Because of the inclination of the iliacus muscle, this region is slightly more superficial than the femoral nerve. The iliacus muscle forms a ridge because of the underlying bone of the superior pubic ramus. The deep circumflex artery lies superficial to the fascia iliaca 1 to 2 cm proximal to the inguinal ligament. This artery is 2 to 3 mm in diameter and lies on the central side of the iliacus ridge. Tilting the transducer laterally enhances imaging of the fascia iliaca due to its inclination.1
In-plane approach from distal to proximal is used. For this block it is critical that the needle tip be positioned between the fascia iliaca and iliacus muscle,2
