Maverick Modules (23-26) PENG, LFCB, PSB, & Post-Op Flashcards
What are indications for a PENG (Pericapsular Nerve Group) block?
Anything involving Hip Joint & Femoral Neck
- Hip arthroscopy
- Total Hip Replacement
- Femoral Neck Fracture
What are the advantages of a PENG block?
- ↓ Opioids
- ↓ MAC (especially good for elderly)
PENG block can be combined with ___________ block to provide complete analgesia for many hip procedures.
LFCN (Lateral Femoral Cutaneous Nerve)
What makes PENG blocks superior to Fascia Iliaca (FICB) and Lumbar Plexus (LP) blocks?
PENG will reliably anesthetize obturator nerve branches that are missed by FICB and LPB’s.
What are the contraindications for PENG block?
- Patient Refusal
- Infection at site
- LA allergy
- Severe Bleeding Disorder
What does AIIS stand for in the picture below?
What does the red line indicate?
- Anterior Inferior Iliac Spine
- Field of LA spread
What nerve (and origins) are noted by the green line below?
Obturator Nerve (L2-L4)
What nerve (and origins) are noted by the blue line below?
Accessory Obturator Nerve (L3-L4)
What nerve (and origins) are noted by the yellow line below?
Femoral Nerve (L2-L4)
When performing a PENG block, the ultrasound probe should be parallel to the _____ ______.
Inguinal Crease
What dose of LA is necessary for post-op pain control with a PENG block?
What dose would be necessary for surgical analgesia?
Failure to capture ________________ nerve may be interpreted as a failed PENG block. (Though it is not)
Lateral Femoral Cutaneous Nerve
What are indications for LCFN (Lateral Cutaneous Femoral Nerve) Block?
- Surgical Incision on lateral thigh
- Adjunct to other blocks (Typically PENG)
Where is the LFCN in relation to the sartorius?
About 1cm superficial to the sartorius
How much volume of LA is necessary for an LFCN block?
5 - 10 mL
