Résumé
The lumbar plexus innervates the anteromedial part of the upper lower limb. Knee and hip surgery are functional surgeries with potentially severe post-operative pain and a high incidence of chronic pain. Multimodal analgesia, insufficient to ensure postoperative rehabilitation alone, must generally be associated with regional analgesia involving the lumbar plexus and its branches. The classical plexus and trunk approaches, such as the femoral nerve block, have been deleted in favor of infiltrative or interfascial techniques. Among the more distal blocks, the PENG block, the adductor canal block, and surgical infiltration of the surgical site have the advantage of reducing the incidence of quadriceps motor block induced by the more proximal classical nerve blocks. The major disadvantage of the more distal approaches remains a lower quality of analgesia, particularly beyond the first few hours, and the absence of continuous postoperative injection. Each team must agree, for each type of surgical procedure, on a combination of techniques that can combine patient comfort, surgical requirements, and rehabilitation.