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Blocking the Distal Superficial Femoral Nerve Branches

Dr. Gregory Hickman

The distal branches of the superficial nerve innervate the anterior distal thigh and knee and are located superficial to the sartorius muscle in the mid-thigh.  Watch as Dr. Hickman uses high resolution ultrasound to clearly identify the tissue plane where these nerves reside, and guides his needle to infiltrate the region for a successful block prior to knee surgery.

Specialties: Anesthesiology, Pain Management, Regional Anesthesia
Applications: Nerve
here you can see the sartorius we've got our femoral artery right here in the middle of sartorius about mid thigh our sapness nerve now let's take a look at something we've never paid attention to for let's go up a little bit more proximally and look right here that looks kind of like a nerve that looks kind of like a nerve and that looks kind of like a nerve we'll show you how easy it is i'm just going to come right in here around one of these nerves and inject in this area and then we'll come back and inject in this area and then we'll inject in this area sometimes we'll just infiltrate right across so this is our typical patient you can see we're about a centimeter deep now this is an nfl player i just did uh like a week ago and you can see from the skin to his sartorius is like a half a centimeter deep or less so this guy doesn't have the fat that last patient had on on them over the sartorius so on this one you can see what maybe looks like a nerve here here and here but on this one it was really easy i just infiltrated right across through there and just sort of just spread the local along on top of the sartorius so there we go real simple approach real simple technique pretty superficial on a guy that doesn't have a lot of body fat

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