studies have shown infrainguinal approach to the ficb as shown in the video really are not useful as attempt in blocking the lfcn and obturator nerve reliably. You are only able to reliably block the femoral nerve, the lfcn only 25% of the time, and almost never for the obturator nerve. a more appropriate approach would be the suprainguinal.
Thanks for the video and your efforts. Kindly clarify again that local anesthetic toxicity is systematic or systemic. Probably you meant "systemic toxicity" and wrongly said "systematic toxicity".
Dear Guys, thanks for the video, allways this kind of activities are a positive contribution, but I dare to do some comments. I realice that you cleaned the skin, but i hope gel was sterile, and also the probe whitout cover, and your gloves. Refering to the ultrasound machine screen , i think could be set in a better view to apreciate the facia more adecuately ( unless it´s your video camera ) grettings
Must be done under sterile condition, especially when you mention an infection as a possible complication, in order to have better results you must do suprainguinal fascia iliaca block , not a femoral nerve block with 50cc , and why ropivacaine 1% ?? Injection must be done from caudat to cranial direction to in order to favorise local anesthetic to move towards pelvis just under fascia iliaca, that helps you to anesthestize articular branches of femoral and obturator. At that point where you make a puncture lateral femoral cutaneous nerve must be visible in this model, just make sure you don’t hit it, as it lies over sartorius muscle or between tensor fascia lata and sartorius There is no fascia iliaca muscle !!! Did you even look at your video before uploading it??
Femoral block targets the femoral nerve directly. Fascia Iliaca block targets the fascia that encompasses the femoral nerve. So some of the local gets to the femoral nerve. But most tracks upwards towards pelvis and blocks some accessory nerves. The best block is a super Inguinal fascia iliaca block.
Overall good video. I do similar no touch technique. No need for drape etc for single shot block. Only comment is that using gel out of the bottle that sits on the ultrasound machine is not sterile. Particularly as in this video where the needle is going through the gel on skin. Who knows what bugs are in that gel. So for any needling I use sterile gel out of small sachet (gel from the bottle should only be for when just scanning and no needling). Or at the very least if no sterile gel I would ensure there is no gel from the non sterile bottle on the skin that needle goes through. I see trainees do this all the time with the non sterile gel from the bottle. Same when using ultrasound to place an iv or arterial line. Any needling needs to be with single use sterile gel. Or needling away from (not through) where the gel has been on the skin.
studies have shown infrainguinal approach to the ficb as shown in the video really are not useful as attempt in blocking the lfcn and obturator nerve reliably. You are only able to reliably block the femoral nerve, the lfcn only 25% of the time, and almost never for the obturator nerve. a more appropriate approach would be the suprainguinal.
Thank you for sharing the knowledge of this technique. I speak here in Brazil, know that your teachings helped someone here!
Thank for you video
Poor needle visualisation.
Fascia iliaca muscle... ?
That was great explanation thank you!!When doing it on the left do you flip the probe so that the marker on the side is pointing lateral?
Thank you volunteer!
Thank you for the detailed explanation. Did you use a 10cm needle?
Thanks for the video and your efforts. Kindly clarify again that local anesthetic toxicity is systematic or systemic. Probably you meant "systemic toxicity" and wrongly said "systematic toxicity".
Excellent video....Thank you both. I work at MPH at Taunton....very professional.
Dear Guys, thanks for the video, allways this kind of activities are a positive contribution, but I dare to do some comments. I realice that you cleaned the skin, but i hope gel was sterile, and also the probe whitout cover, and your gloves. Refering to the ultrasound machine screen , i think could be set in a better view to apreciate the facia more adecuately ( unless it´s your video camera )
grettings
Must be done under sterile condition, especially when you mention an infection as a possible complication, in order to have better results you must do suprainguinal fascia iliaca block , not a femoral nerve block with 50cc , and why ropivacaine 1% ?? Injection must be done from caudat to cranial direction to in order to favorise local anesthetic to move towards pelvis just under fascia iliaca, that helps you to anesthestize articular branches of femoral and obturator. At that point where you make a puncture lateral femoral cutaneous nerve must be visible in this model, just make sure you don’t hit it, as it lies over sartorius muscle or between tensor fascia lata and sartorius
There is no fascia iliaca muscle !!!
Did you even look at your video before uploading it??
I fully agree with you.
Thank you
what's the difference this and femoral nerve block?
Femoral block targets the femoral nerve directly. Fascia Iliaca block targets the fascia that encompasses the femoral nerve. So some of the local gets to the femoral nerve. But most tracks upwards towards pelvis and blocks some accessory nerves. The best block is a super Inguinal fascia iliaca block.
Sterility?
Overall good video. I do similar no touch technique. No need for drape etc for single shot block. Only comment is that using gel out of the bottle that sits on the ultrasound machine is not sterile. Particularly as in this video where the needle is going through the gel on skin. Who knows what bugs are in that gel. So for any needling I use sterile gel out of small sachet (gel from the bottle should only be for when just scanning and no needling). Or at the very least if no sterile gel I would ensure there is no gel from the non sterile bottle on the skin that needle goes through. I see trainees do this all the time with the non sterile gel from the bottle. Same when using ultrasound to place an iv or arterial line. Any needling needs to be with single use sterile gel. Or needling away from (not through) where the gel has been on the skin.
I’ve never heard of ropivacaine 1%.
Not equipotent to 0.25% bupi. Surgical concentration
En castellano
Very poor needle visualization
poor needle tip visualization
Very bad video, basically teaches you nothing
Why on Earth they have shots from the ceiling when was most important to see the US.