Radial plus musculocutaneous nerve stimulation for axillary block is inferior to triple nerve stimulation with 2% mepivacaine

Rodríguez, Jaime; Taboada, Manuel; Oliveira, Juan; Ulloa, Beatriz; Bascuas, Begoña; Álvarez, J.

doi:10.1016/j.jclinane.2007.11.004

Cited by 7 publications

(2 citation statements)

References 12 publications

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“…Rodriguez et al [38] compared two different nerve stimulation techniques in a randomized and investigatorblinded study of 60 patients. In a double stimulation group, only the radial and musculocutaneous nerves were stimulated, whereas in a triple stimulation group, the Brachial plexus block with or without ultrasound guidance Klaastad et al 657 median nerve was also stimulated.…”

Section: Axillary Blocksmentioning

confidence: 99%

Brachial plexus block with or without ultrasound guidance

Klaastad

Sauter

Dodgson

2009

Current Opinion in Anaesthesiology

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Section: Axillary Blocksmentioning

confidence: 99%

Brachial plexus block with or without ultrasound guidance

Klaastad

Sauter

Dodgson

2009

Current Opinion in Anaesthesiology

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“…Block success rates of the MCN can range from 27 to 40 % as seen in a study without a selective block of the nerve [6]. With a selective block on the other hand, success rates for MCN blocks above 90 % are achieved [6–8]. …”

Section: Discussionmentioning

confidence: 99%

The relationship of the musculocutaneous nerve to the brachial plexus evaluated by MRI

Kjelstrup

Sauter

Hol

2015

J Clin Monit Comput

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Axillary plexus blocks (AXB) are widely used for upper limb operations. It is recommend that AXB should be performed using a multiple injection technique. Information about the course and position of the musculocutaneous nerve (MCN) is of relevance for AXB performance. The objective of this study was to examine the position of the MCN and its relationship to the axillary sheath using MRI. 54 patients underwent an AXB with 40 ml of local anaesthetic before MRI examination. The course of the MCN and the position where it left the axillary sheath and perforated the coracobrachial muscle (MCN exit point), in relation to the axillary artery and the block needle insertion point in the axillary fold, were recorded. The MCN was seen clearly in 23, partly in 26, and not identified in five patients at the MCN exit point. The mean distance from the insertion point of the block needle in the axillary fold to the MCN exit point was 36.8 mm (SD = 18.9, range: 0–90.5). In 37 patients the MCN exit point was positioned inside the Q1 quadrant (lateral anterior to the axillary artery) and in 11 patients inside the Q2 quadrant (medial anterior to the axillary artery). There is a wide variability as to where the musculocutaneous nerve (MCN) leaves the axillary sheath. Therefore multiple injection techniques, or the use of a proximally directed catheter, should be appropriate to block the MCN.

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