The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica

  • Kim, Jeong-Eun (Departmetn of Anesthesiology and Pain Medicine, Daegu Fatima Hospital) ;
  • Lee, Sang-Gon (Departmetn of Anesthesiology and Pain Medicine, Daegu Fatima Hospital) ;
  • Kim, Eun-Ju (Departmetn of Anesthesiology and Pain Medicine, Daegu Fatima Hospital) ;
  • Min, Byung-Woo (Departmetn of Anesthesiology and Pain Medicine, Daegu Fatima Hospital) ;
  • Ban, Jong-Suk (Departmetn of Anesthesiology and Pain Medicine, Daegu Fatima Hospital) ;
  • Lee, Ji-Hyang (Departmetn of Anesthesiology and Pain Medicine, Daegu Fatima Hospital)
  • Received : 2011.02.24
  • Accepted : 2011.04.04
  • Published : 2011.06.01
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Abstract

Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.

Keywords

References

  1. Shannon J, Lang SA, Yip RW, Gerard M. Lateral femoral cutaneous nerve block revisited. A nerve stimulator technique. Reg Anesth 1995; 20: 100-4.
  2. Bodner G, Harpf C, Gardetto A, Kovacs P, Gruber H, Peer S, et al. Ultrasonography of the accessory nerve: normal and pathologic findings in cadavers and patients with iatrogenic accessory nerve palsy. J Ultrasound Med 2002; 21: 1159-63. https://doi.org/10.7863/jum.2002.21.10.1159
  3. Eichenberger U, Stockli S, Marhofer P, Huber G, Willimann P, Kettner SC, et al. Minimal local anesthetic volume for peripheral nerve block: a new ultrasound-guided, nerve dimension-based method. Reg Anesth Pain Med 2009; 34: 242-6. https://doi.org/10.1097/AAP.0b013e31819a7225
  4. Grossman MG, Ducey SA, Nadler SS, Levy AS. Meralgia paresthetica: diagnosis and treatment. J Am Acad Orthop Surg 2001; 9: 336-44. https://doi.org/10.5435/00124635-200109000-00007
  5. Keegan JJ, Holyoke EA. Meralgia paresthetica: an anatomical and surgical study. J Neurosurg 1962; 19: 341-5. https://doi.org/10.3171/jns.1962.19.4.0341
  6. Bjurlin MA, Davis KE, Allin EF, Ibrahim DT. Anatomic variations in the lateral femoral cutaneous nerve with respect to pediatric hip surgery. Am J Orthop 2007; 36: 143-6.
  7. Ng I, Vaghadia H, Choi PT, Helmy N. Ultrasound imaging accurately identifies the lateral femoral cutaneous nerve. Anesth Analg 2008; 107: 1070-4. https://doi.org/10.1213/ane.0b013e31817ef1e5
  8. Lee HK, Chung SY, Lee SY, Suh YS, Kim C. Management of meralgia paresthetica by lateral femoral cutaneous nerve block: case reports. Korean J Pain 1995; 8: 152-5.
  9. Sharrock NE. Inadvertent "3-in-1 block" following injection of the lateral cutaneous nerve of the thigh. Anesth Analg 1980; 59: 887-8.
  10. Brown DL. Atlas of regional anesthesia. 2nd ed. Philadelphia, WB Saunders. 1999, p 114.
  11. Hurdle MF, Weingarten TN, Crisostomo RA, Psimos C, Smith J. Ultrasound-guided blockade of the lateral femoral cutaneous nerve: technical description and review of 10 cases. Arch Phys Med Rehabil 2007; 88: 1362-4. https://doi.org/10.1016/j.apmr.2007.07.013

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