Fascia Iliaca Block

Authors: Anna Forbes, Tapi Kundishora, James Waiting / Editors: James Waiting / Reviewer: Thomas MacMahon, Mohammed Hamza / Codes: / Published: 27/02/2023

Learning objectives

After completing this module you will be able to:

  • Understand the nerves blocked by the fascia iliaca block and its indications including pain relief for fractured neck of femur patients.
  • Be aware of the contraindications to performing fascia iliaca block.
  • Understand the sonographic anatomy for fascia iliaca block.
  • Be able to calculate the dose of local anaesthetic
  • Understand the required post block monitoring and be able to recognise local anaesthetic toxicity.
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References

  1. Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesth Analg. 1989 Dec;69(6):705-13. Erratum in: Anesth Analg 1990 Apr;70(4):474.
  2. Scurrah A, Shiner CT, Stevens JA, Faux SG. Regional nerve blockade for early analgesic management of elderly patients with hip fracture – a narrative review. Anaesthesia. 2018 Jun;73(6):769-783.
  3. Lewis SR, Price A, Walker KJ, McGrattan K, Smith AF. Ultrasound guidance for upper and lower limb blocks. Cochrane Database Syst Rev. 2015 Sep 11;2015(9):CD006459.
  4. Fadhlillah F, Chan D, Pelosi P, Rubulotta F. Systematic review and meta-analysis of single injection fascia iliaca blocks in the peri-operative management of patients with hip fractures. Minerva Anestesiol. 2019 Nov;85(11):1211-1218.
  5. Amin NH, West JA, Farmer T, Basmajian HG. Nerve Blocks in the Geriatric Patient With Hip Fracture: A Review of the Current Literature and Relevant Neuroanatomy. Geriatr Orthop Surg Rehabil. 2017 Dec;8(4):268-275.
  6. Morrison RS, Magaziner J, Gilbert M, Koval KJ, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003 Jan;58(1):76-81.
  7. Membership of the Working Party; Griffiths R, Alper J, Beckingsale A, et al. Management of proximal femoral fractures 2011: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2012 Jan;67(1):85-98.
  8. National Institute for Health and Clinical Excellence. Hip fracture: management. NICE Clinical guideline [CG124], 2011. Last updated: 06 January 2023.
  9. Bulger JK, Brown A, Evans BA, Fegan G, Ford S, Guy K, et al. Rapid analgesia for prehospital hip disruption (RAPID): protocol for feasibility study of randomised controlled trial. Pilot and feasibility studies. 2017;3:8.
  10. Association of Anaesthetists of Great Britain and Ireland, Regional Anaesthesia UK. Fascia iliaca blocks and non-physician practitioners. AAGBI position statement 2013 London.
  11. Association of Anaesthetists of Great Britain and Ireland, Obstetric Anaesthetists Association, Regional Anaesthesia UK. Regional anaesthesia and patients with abnormalities of coagulation. Anaesthesia. 2013;68(9):966-72.
  12. Kumar N S, N K, M R, Sebastian D, Gowda Rm P. Dexamethasone as an additive to bupivacaine in fascia lliaca compartment block: a prospective, randomized and double blind study. J Clin Diagn Res. 2014 Aug;8(8):GC05-8.
  13. Gristwood RW. Cardiac and CNS toxicity of levobupivacaine: strengths of evidence for advantage over bupivacaine. Drug safety. 2002;25(3):153-63.
  14. Christie LE, Picard J, Weinberg GL. Local anaesthetic systemic toxicity. BJA Education. 2015;15(3):136-42.
  15. Royal College of Emergency Medicine (RCEM). Fascia Iliaca Block (FIB) Safety Newsflash, 2018.

Module Content

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