Femoral Triangle Block

In this short video, Dr Pawa discusses an approach to the femoral triangle block with some anatomy, tips and tricks.
This Video forms part of his nerve blocks related to knee arthroplasty

[@daniellee6285]

Love your videos. Very insightful. I am but a mere dnap student who will likely be doing this block and an ipack tomorrow. I watched your ipack block video as well. You are doing great things.

[@DrAmitPawa]

Thank you so much for taking the time to watch and also feedback on the videos. It’s really great to know that they are being put to good use. Good luck for the blocks.

[@adrianwaterman133]

Appreciate the videos

[@DrAmitPawa]

Thanks so much

[@thenomadicDR]

hi. for posterior knee pain, would you recommend saphenous nerve block or ipack block?

[@DrAmitPawa]

For posterior knee pain there are a few options:
1. Surgical Local Anaesthetic infiltration at time of surgery
2. IPACK block
3. Distal Adductor Canal block aiming for LA to follow the Path to the back of the knee.
My Preference is for ipack block

[@thenomadicDR]

@@DrAmitPawa if the pain is more over the semimembranosus/semitendinosus region, i probably should go for distal adductor canal block right?

[@drnikhilsharma8179]

Will this be good for infrageniculate exposure of the popliteal artery?

[@DrAmitPawa]

Potentially could be I guess. Makes sense!

[@akbruthven]

Thanks for a really interesting video. The world of adductor canal vs femoral triangle blocks, the vastoadductor membrane and NVM is certainly a confusing one. My understanding based on articles like this (www.ncbi.nlm.nih.gov/pmc/articles/PMC6625309/) is that the vastoadductor membrane begins at the apex of the femoral triangle (moving distally) meaning a subsartorial block at this point or just proximal as you demonstrate should reliably get both nerves. And I think your video of the block does demonstrate this - all your initial LA seems to dissect sartorius from its underlying fascia, but at 7:53 (when you say you are piercing the VAM) the LA suddenly surrounds BOTH the saphenous & NVM with a single injection, presumably because there is no VAM at this point. The end result is beautiful but my interpretation is slightly different to what you describe. Food for thought...

[@DrAmitPawa]

Thank you so much for your incredibly insightful information and Knowledge.
Really appreciate it

[@paulgilbert2506]

Nothing is more annoying than an US video that does not explicitly show medial/lateral on the US image.

[@DrAmitPawa]

So sorry that you were not happy with this. The labelled image overlays display this information. Sorry this was not useful for you

[@paulgilbert2506]

@@DrAmitPawa It is helpful to have Medial/Lateral displayed at all times. I really dont understand why educational videos do not do this.
I made the comment prior to the overlay showing up.
Maybe in future videos, display medial/lateral on ALL images to orient less experienced practitioners.

[@DrAmitPawa]

@@paulgilbert2506 thanks for your comments. Many of my videos have this. This video was an abbreviated version of the full knee video that has the labels as you desire. Where the probe animation is displayed over the part of the body- this is meant to act as a surrogate guide. I appreciate you taking the time to comment