Fascia iliaca compartment block: A narrative review

Abstract

Fascia iliaca compartment block (FICB) is a plane block, targeting the three main branches of the lumbar plexus, including the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. It is a useful regional anaesthesia technique for lower limb procedures, particularly for hip and knee surgeries. While both traditional landmark-based and newer ultrasound-guided approaches exist, the latter offers more reliable coverage of the target nerves. Through this narrative review, we wish to bring forth the anatomical considerations that need to be kept in mind, as well as the indications and contraindications of administering an ultrasound-guided FICB. The review describes in detail the two main approaches of ultrasound-guided FICB, including the infrainguinal and suprainguinal approaches, with emphasis on the fact that the suprainguinal approach provides a more extensive spread of local anaesthetic (LA), a more reliable blockade of the obturator nerve, greater pain relief, and reduced opioid consumption. Further, being a plane block, a large volume of LA needs to be administered for adequate effect. To conclude, ultrasound-guided FICB is a superficial, safe, and easy-to-learn block with a low complication rate.