The lateral femoral cutaneous nerve emerges from the lateral border of the psoas major muscle and crosses the iliacus muscle obliquely toward the anterior superior iliac spine, where it supplies the parietal peritoneum of the iliac fossa. The main landmark for lateral femoral cutaneous nerve block is the anterior superior iliac spine. The patient is in a supine position and the anterior superior iliac spine is palpated and marked. In some patients however, the nerve can provide surprisingly large innervation territory of the anterior thigh as well. The lateral femoral cutaneous nerve provides sensation to the anterolateral aspect of the thigh (see Figure 1). Its use has also been reported as a diagnostic tool for meralgia paresthetica, neuralgia of the lateral femoral cutaneous nerve of the thigh. This block can be used to provide complete anesthesia in patients undergoing skin graft on the lateral aspect of the thigh, or it can be combined with femoral block or sciatic block. Choice of anesthetic for cutaneous nerve block of the lower extremity. The contraindications to performing cutaneous nerve blocks of the lower extremity are few, but include local infection at the sites of needle insertion, and allergy to local anesthetic. The saphenous, sural, and superficial peroneal nerve blocks can be used as part of an ankle block to provide complete anesthesia to the foot and ankle, or they can be used separately to provide anesthesia to specific portions of the foot and ankle. The lateral femoral cutaneous nerve block has been used to provide anesthesia for pediatric patients undergoing muscle biopsy and to provide analgesia after femoral neck surgery in older patients. The posterior femoral cutaneous nerve block is used for any surgical procedure performed on the posterior aspect of the thigh. Vloka and Luc Van Keer INTRODUCTIONÄ«locks of the lateral femoral cutaneous, posterior femoral cutaneous, saphenous, sural, and superficial peroneal nerves are useful anesthetic techniques for a variety of superficial surgical procedures and carry a low risk of complications. Table of Contents Cutaneous Nerve Blocks of the Lower Extremity
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