Axillary
AXILLARY BLOCK
Author: Valeria Mossetti
1. Indications
Axillary block provides anesthesia and analgesia for surgery on forearm and hand.
For extensive elbow surgery consider more proximal technique.
2. Contraindications
Local infection
3. Anatomy
In the axilla, the terminal branches of the brachial plexus (ulnar, median, and radial
nerves) meet near the artery. The musculocutaneus nerve, however, branches off
more proximally from the plexus cords and proceeds from there dorsally and
cranially while remaining near the plexus in the axillary region.
4. Technique
The patient is positioned as for a classical axillary approach, i.e. supine with the arm
abducted at 90°C and the forearm flexed.
Use a linear high-frequency probe with 10 or 12 MHz. For smaller patients, if
possible, use a small footprint linear probe (25 mm). If required, identify the nerves
using the nerve stimulator: common response to neurostimulator is the hand and
fingers contraction.
Place the probe perpendicularly on the arm as close to the axilla as possible in the
hollow formed between the biceps and the pectoralis muscle so that the plexus can
be scanned transversely…