Anatomy

The femoral nerve is the largest branch of the lumbar plexus and enters the thigh lateral to the femoral artery in its own fascial sheath (Figure RA.31). It can be discretely blocked as a single nerve using 10 ml solution but a large volume (20-30 ml) produces, in effect, a distal approach to the lumbar plexus which also blocks the obturator nerve and lateral cutaneous nerve of thigh the so-called "3 in 1' block (Winnie 1973), although there is some uncertainty whether all three nerves are reliably blocked with this approach.

Figure RA.31 Anatomy of the femoral nerve in cross section

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