Lower Extremity Blocks: Femoral Nerve Block and Adductor Canal Block

Abstract

Femoral nerve supplies the front of thigh and knee joint. Medial aspect of leg and the foot is supplied by its terminal branch: saphenous nerve. Both nerves can be blocked to provide either anesthesia or postoperative analgesia for surgery. Femoral nerve is usually blocked at the level of the inguinal crease although it can be blocked through different approaches like Fascia Iliaca block or as three in one block. Saphenous nerve can be blocked at various levels through a subsartorial approach in the femoral or adductor canal, near tibial tuberosity or at the level of the ankle joint. Adductor canal block has become more popular since the availability of ultrasound. Combination of sciatic and femoral or saphenous nerves is used to provide anesthesia or analgesia of any part of the lower extremity. To avoid the risk of muscle weakness and fall after surgery, the adductor canal block is becoming much more common to provide postoperative pain relief after knee surgery.