64447 Injection(s), anesthetic agent(s) and/or steroid; femoral nerve

Name of the Procedure:

Injection(s), anesthetic agent(s), and/or steroid; femoral nerve block
Common name(s): Femoral nerve block, Femoral nerve injection

Summary

A femoral nerve block is a medical procedure where an anesthetic and/or steroid is injected around the femoral nerve. This is to provide pain relief for surgical procedures on the leg, hip, or knee, or to manage chronic pain conditions.

Purpose

Medical condition or problem it addresses:

• Postoperative pain after leg, knee, or hip surgery
• Chronic pain conditions affecting the leg or hip

Goals or expected outcomes:

• Provide immediate and temporary pain relief
• Facilitate surgical procedures without general anesthesia
• Improve postoperative recovery and mobility

Indications

Specific symptoms or conditions:

• Severe pain following knee or hip surgery
• Chronic pain in the leg or hip not responsive to other treatments

Patient criteria:

• Patients who are undergoing surgery on the thigh, knee, or hip
• Patients with chronic hip or leg pain

Preparation

Pre-procedure instructions:

• Fasting for at least 6-8 hours before the procedure if sedation is needed
• Adjustment or discontinuation of certain medications like blood thinners

Diagnostic tests or assessments:

• Physical examination
• Review of medical history and allergies
• Possible imaging studies to locate the femoral nerve precisely

Procedure Description

A detailed step-by-step explanation:

1. The patient is positioned comfortably, usually lying on their back.
2. The area around the groin is cleaned and sterilized.
3. Local anesthesia is administered to numb the skin and tissues around the injection site.
4. Using ultrasound guidance or nerve stimulator, the physician locates the femoral nerve.
5. A needle is inserted near the femoral nerve.
6. Anesthetic agent and/or steroid is injected through the needle.
7. The needle is removed, and the area is covered with a small bandage.

Tools, equipment, or technology used:

• Sterile gloves and antiseptic solution
• Ultrasound machine or nerve stimulator
• Needle and syringe
• Local anesthetic and/or steroid medication

Anesthesia or sedation:

• Local anesthesia for the injection site
• Sedation may be provided depending on patient anxiety or preference

Duration

The procedure typically takes 15-30 minutes.

Setting

The procedure is performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Anesthesiologist or pain management specialist
• Nursing staff

Risks and Complications

Common risks:

• Localized pain or discomfort at the injection site
• Temporary numbness or weakness in the leg

Rare risks:

• Bleeding or infection at the injection site
• Allergic reactions to the medications used
• Nerve damage

Possible complications:

• Persistent numbness or weakness
• Failure to relieve pain

Benefits

Expected benefits:

• Immediate and effective pain relief
• Reduced need for opioid medications
• Enhanced recovery and mobilization after surgery

Realization timeline:

• Pain relief can often be felt within minutes to hours after the procedure.

Recovery

Post-procedure care:

• Monitoring in the recovery area for a short period
• Avoid strenuous activities for 24 hours

Expected recovery time:

• Most patients can return to normal activities within a day or two.
• Follow-up appointment to assess response and manage any complications.

Alternatives

Other treatment options:

• Oral or intravenous pain medications
• Epidural injections
• Physical therapy for chronic pain management

Pros and cons of alternatives:

• Oral medications may not provide as targeted pain relief
• Epidural injections have a broader effect and may carry different risks
• Physical therapy is less invasive but might not provide immediate relief

Patient Experience

During the procedure:

• Mild discomfort or a prickling sensation when the needle is inserted
• Temporary numbness in the leg after the injection

After the procedure:

• Immediate pain relief
• Possible temporary weakness or numbness in the leg
• Pain management strategies including prescribed pain medications if needed

Pain management and comfort measures:

• Use of ice packs at the injection site if needed
• Over-the-counter pain relievers as advised by the physician