Author: Katie Sprinkle, MD

Educational Pearls:

• The fascia iliaca block is useful for hip and proximal femur fractures.
• Typically involves injecting 40-60 mL of diluted bupivacaine (0.25%) under the fascia iliaca (or other anesthetic)
• Anesthesia is achieved of the femoral, obturator, and lateral femoral cutaneous nerves.
• Monitor for signs of bupivacaine toxicity (paresthesias, AMS, seizures, arrhythmias)
• Intralipid can be an effective treatment for life-threatening toxicity

References:

Hoegberg LC, Bania TC, Lavergne V, Bailey B, Turgeon AF, Thomas SH, Morris M, Miller-Nesbitt A, Mégarbane B, Magder S, Gosselin S; Lipid Emulsion Workgroup.. Systematic review of the effect of intravenous lipid emulsion therapy for local anesthetic toxicity. Clin Toxicol (Phila). 2016 Mar;54(3):167-93. doi: 10.3109/15563650.2015.1121270. Epub 2016 Feb 6. Review. PubMed PMID: 26853119.

https://www.acepnow.com/article/control-hip-fracture-pain-without-opioids-using-ultrasound-guided-fascia-iliaca-compartment-block/?singlepage=1&theme=print-friendly

Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD