Definition
A femoralis catheter is an access to the femoral nerve through which painkillers can be administered (also continuously). These analgesics are directed into the direct vicinity of the nerve and prevent the transmission of pain perception here. It is a method of short- or long-term pain therapy. Other names for the femoralis catheter are “Femoralis block” or “Nervus femoralis blockade”.
Indication for a femoralis catheter
The femoralis catheter is usually used as a pain treatment during or after surgery. The primary goal is of course to expose the patient to as little pain as possible. The femoral nerve, like all nerves, has its own area of innervation. In the case of the femoral nerve, this area is located from the hip downwards, i.e. a large part of the legs. Therefore, the femoralis catheter only makes sense when anesthesizing regions that lie below the hip and are innervated by the femoral nerve.
Procedure and implementation – How is it laid?
The procedure for placing a femoral catheter is as follows: The patient lies on his back and has his leg, on which the procedure takes place, in a slightly spread and outwardly turned position. This allows the anesthetist to easily reach the femoral nerve. The anesthetist then punctures the skin with a puncture needle.
The puncture site is on the side (away from the middle of the body) of the femoral artery, which can be palpated. As soon as the puncture needle is in the skin, the femoral nerve is searched for using a nerve stimulator or ultrasound. If the stimulator is near the femoral nerve, visible muscle twitches occur on the thigh.
This is mainly caused by the characteristic muscle of the femoral nerve, the rectus femoris muscle (also called quadriceps). The movement of the patella can also be observed. The anesthetist may move the puncture needle slightly to find the point of the strongest stimulus response.
From this it can then be concluded that one is in the right place and that the local anesthesia can begin. Alternatively, ultrasound can be used to monitor the puncture of the nerve. The catheter is then pushed a little over the puncture needle so that it remains on the nerve.
In the case of short-term anesthesia, the painkiller is now administered via the catheter and the catheter is then removed. In the case of an indwelling catheter, the puncture needle is removed and the femoralis catheter is attached to the skin via a skin suture. This prevents the catheter from slipping out.
Finally, the puncture site is sterilely covered and painkillers can then be administered to the nerve via the indwelling catheter. Before the femoral nerve is punctured, a local anesthetic is administered. Due to the anesthesia the patient has no pain when the anesthetist searches for the nerve with the help of the puncture needle and punctures it. All in all, the pain of the procedure can be reduced to a small prick by the anesthetic.