Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep;11(4):310-3.

Ultrasound-guided three-in-one nerve block for femur fractures

Steve C Christos  1 , George Chiampas, Ryan Offman, Robert Rifenburg
Affiliations

Ultrasound-guided three-in-one nerve block for femur fractures

Steve C Christos et al. West J Emerg Med. 2010 Sep.

Abstract

Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular and respiratory complications from opiate administration. Ultrasound (US)-guided three-in-one (3-in-1) femoral nerve block (FNB) is an option for pain management in patients with femur fractures, as it provides regional anesthesia to the femoral, obturator and lateral cutaneous nerves. Our goal is to provide medical education regarding the use of US-guided 3-in-1FNB as a rapid and easy procedure that may provide optimal patient care in patients with femur fractures.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Ultrasound probe on right side of patient’s groin
Figure 2.
Figure 2.
Inguinal ligament (IL).
Figure 3a
Figure 3a
Ultrasound image of femoral vein (FV), artery (FA), nerve (FN) and inguinal ligament (IL).
Figure 3b
Figure 3b
Ultrasound image of femoral vein (FV), artery (FA), and nerve (FN) with color flow doppler.
Figure 4.
Figure 4.
Lateral approach of 21 gauge spinal needle with 20 ml of bupivacaine 0.5% on patient’s right side.
Figure 5.
Figure 5.
Ultrasound image of femoral vein (FV), artery (FA), nerve (FN) and inguinal ligament (IL) and expanding bupivacaine around FN.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Antonis MS, Chandwani D, McQuillen K. Ultrasound-guided placement of femoral 3-in-1 anesthetic nerve block for hip fractures. Academic Emergency Medicine. 2006;13:S122–3.
    1. O’Donnell BD, Mannion S. Ultrasound-guided femoral nerve block, the safest way to proceed? Reg Anesth Pain Med. 2006;31:387–8. - PubMed
    1. Marhofer P, Schrogendorfer K, Koinig H, Kapral S, Weinstable C, Mayer N. Ultrasoundographic guidance improves sensory block and onset time of three-in-one blocks. Anesthesia and Analgesia. 1997;85:854–7. - PubMed
    1. Snoeck MM, Vree TB, Gielen MJ, Lagerwert AJ. Steady state bupivacaine plasma concentrations and safety of a femoral “3-in-1” nerve block with bupivacaine in patients over 80 years of age. International Journal of Clinical Pharmacology and Therapeutics. 2003;41:107–13. - PubMed
    1. Fletcher AK, Rigby AS, Hayes FL. Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial. Annals of Emergency Medicine. 2003;41:227–33. - PubMed