Ultrasound-Guided Fascia Iliaca Block ( Supra-inguinal Technique)



Nerves Blocked: Femoral nerve, lateral cutaneous nerve of thigh +/- obturator nerve


Location: Below fascia iliaca to block branches of lumbar plexus


Difficulty: Green/ Blue


Indications: Fractures of hip & proximal femur. Surgery on hip, anterior thigh & knee 


Patient Position: Supine


Needle: 50-100mm short beveled regional block needle


Probe: High frequency linear


Tiger Territory: Bowel

Femoral vessels


Think Twice if: Previous vascular surgery in ipsilateral groin


Image optimisation: Screen depth 3 - 5 cm

Ultrasound probe perpendicular inguinal ligament 

Scan along the inguinal ligament

Best image is usually just off the anterior superior iliac spine






Needling:   In-Plane 

• Caudad to cephalad/medial direction (enable cephalad spread local anaesthetic)

• Needle tip should be positioned just under the fascia iliaca.


Complications/ SEs: Higher risk of local anaesthetic toxicity (as large volumes local anaesthetic used)


Pearls: Larger volumes will achieve greater spread of local anaesthetic and coverage of nerves

• Use a minimum of 30ml in an adult

• Dilute the concentration as necessary to keep within a safe dose of local anaesthetic

When injected in correct position fascia iliaca should peel away from the iliacus muscle

Catheter insertion is useful for continuous infusion of local anaesthetic, or intermittent boluses