FASCIA ILIACA BLOCK

ON CALL FASCIA ILIACA PROTOCOL

Supplies Needed at bedside

  • Ropivacaine 0.2% or 0.5% (will need an injection of 30-40cc, check dosage chart below)

  • Decadron 6mg (Order as 10mg IV solution and draw up as needed)

  • **20% Lipid Emulsion must be readily available**

  • Blunt tip

  • Extension tubing

  • 60cc syringe

  • Sterile gloves

  • 20g or 22g spinal needle

  • Chlorhexidine swabs

  • Drape

  • Sterile probe cover

  • Ultrasound machine with linear probe


Ropivacaine Dosage Chart

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Relevant Anatomy

Femoral nerve and lateral femoral cutaneous nerves lie deep to the fascia iliaca, adjacent to the iliacus muscle. Femoral vein and artery lie superficial to this fascia. Both nerves begin branching extensively proximally and so care should be taken to perform injection of anesthesia as close to the inguinal ligament as possible, though some spreading superiorly will occur.

Ultrasonography

Identify femoral artery superiorly in the groin prior to any branches

Slide laterally to identify iliacus muscle and overlying fascia (possibly identify femoral nerve)

Insert needle lateral to target area and advance under in plane visualization


Additional Resources

NYSORA Fascia Iliaca Block

ACEP Now Fascia Iliaca Block


Fascia Iliaca Block Google Page Build

 

Authors

Mark Noble, MD

Matt Jones, MD

Don Byars, MD

Image Contributors