Randomized comparative study between two different techniques of intercostobrachial nerve block together with brachial plexus block during superficialization of arteriovenous fistula

Moustafa, Moustafa Abdelaziz; Kandeel, Alaa Abdelrahman

doi:10.1007/s00540-018-2547-z

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…Thoracic wall blocks administered immediately superficial or deep to the serratus anterior muscle target the lateral cutaneous branches of thoracic spinal nerves [6][7][8]. Hence, serratus plane blocks performed at the second or adjacent rib can produce an intercostobrachial nerve blockade.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, serratus plane blocks performed at the second or adjacent rib can produce an intercostobrachial nerve blockade. Indeed, Moustafa and Kandeel [8] showed that to block the intercostobrachial nerve, injecting between the pectoralis minor and serratus anterior muscles at the level of the third rib in the anterior axillary line provided a significantly higher success rate compared with subcutaneous injection along the medial side of the upper arm. Furthermore, ultrasound-guided local anesthetic infiltration in the proximity of the medial brachial cutaneous and intercostobrachial nerves on the surface of the latissimus dorsi muscle at the axilla has been reported with a success rate of 92.9% [4].…”

Section: Discussionmentioning

confidence: 99%

“…The intercostobrachial nerve is the lateral cutaneous branch of the ventral ramus of the second thoracic spinal nerve [5]. Blockade of the intercostobrachial nerve can be achieved by ultrasound-guided local anesthetic infiltration in the axilla [4] or in the serratus plane [6][7][8]. Paravertebral blocks performed at high thoracic levels also involve the second thoracic spinal nerve.…”

Section: Introductionmentioning

confidence: 99%

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Blockade of intercostobrachial nerve by an erector spinae plane block at T2 level: a case report

Yoshida

Nakamoto

2023

JA Clin Rep

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Background The intercostobrachial nerve blockade is required, in addition to brachial plexus block, to anesthetize the entire upper arm. No studies have described the use of erector spinae plane (ESP) block for an intercostobrachial nerve block. Case presentation A 72-year-old man was scheduled to undergo left brachial vein transposition-arteriovenous fistula creation for hemodialysis access. An ultrasound-guided infraclavicular brachial plexus block was performed using a mixture of 0.5% levobupivacaine (12.5 ml) and 2% lidocaine (12.5 ml). An ESP block was implemented using 10 ml of the same local anesthetic at the T2 level. A pinprick test showed that the entire upper arm and lateral aspect of the left upper chest wall were anesthetized 20 min after the blocks. Surgery was successfully performed without the need for general anesthesia. Conclusions In the present case, an ESP block performed at the T2 level provided sensory loss of the area innervated by the intercostobrachial nerve.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Blockade of intercostobrachial nerve by an erector spinae plane block at T2 level: a case report

Yoshida

Nakamoto

2023

JA Clin Rep

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“…Anesthetic coverage via a brachial plexus block alone is often inadequate, particularly when the surgical procedure extends into the proximal axilla. Although inclusion of an ICBN (T2) covers the T2 dermatomal distribution outside of the brachial plexus (C5-T1) [4,5], the ICBN performed subcutaneously may only achieve 50-90% adequate coverage with significant anatomic variability [6,7]. A high thoracic PVB can mitigate this weakness by supplying coverage of the necessary T1-2 dermatomes.…”

Section: Discussionmentioning

confidence: 99%

“…Because the ICBN originates from the T2 nerve root below the C5-T1 nerve roots comprising the brachial plexus, brachial plexus blocks are ideally supplemented with an ICBN infiltration block for medial, upper arm coverage [4,5]. Unfortunately, the ICBN block performed subcutaneously may only achieve 50-90% adequate coverage [6], likely stemming from significant anatomic variability [7].…”

Section: Introductionmentioning

confidence: 99%

Beyond the Brachial Plexus: Reapplication of the Thoracic Paravertebral Block for Upper Arm Fistula Surgery

Le¹,

Grant²

2023

Cureus

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Patients requiring complex upper arm arteriovenous fistulas or grafts may not be suitable candidates for a single regional anesthesia technique and monitored anesthesia care because the necessary thoracic (T2) dermatomal area of the medial, upper arm remains spared by any solitary brachial plexus (C5-T1) technique. An infiltrative intercostobrachial nerve block can often be used in conjunction with a brachial plexus block; however, coverage may still be incomplete. This case report describes the use of a high thoracic paravertebral block in conjunction with a brachial plexus block to achieve adequate anesthetic coverage for an upper arm arteriovenous fistula creation procedure extending into the axilla. The result of this technique showed adequate coverage of the upper arm and demonstrates that paravertebral blocks are a reasonable adjunct for proximal upper arm arteriovenous fistula procedures.

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Advancing pain management for extremity trauma: the evolution of ultrasound-guided nerve blocks for patients in the supine position in trauma centers

Huaguo,

Kang,

et al. 2024

Eur J Trauma Emerg Surg

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Purpose Trauma, particularly extremity trauma, poses a considerable challenge in healthcare, especially among young adults. Given the severity of patient pain and the risks associated with excessive opioid use, managing acute pain in trauma centers is inherently complex. This study aims to investigate the application and benefits of ultrasound-guided nerve blocks for early pain management in patients with extremity trauma positioned supine. Methods A comprehensive literature review was conducted to assess the effectiveness and advantages of ultrasound-guided peripheral nerve blocks in the acute pain management of extremity trauma patients in the supine position. Special emphasis was placed on evaluating the selection criteria, indications, contraindications, adverse reactions, and potential complications associated with these nerve block techniques. Results Ultrasound-guided nerve blocks represent a safer and more precise option for managing pain in extremity trauma patients placed in the supine position. These techniques offer significant advantages in terms of reducing healthcare expenses, diminishing reliance on opioid medications, and mitigating opioid-related complications. Nonetheless, challenges may arise due to the necessity for patient cooperation during specific nerve block procedures. Conclusion Ultrasound-guided nerve blocks present a promising avenue for early pain management in extremity trauma patients positioned supinely. Their implementation can lead to improved patient outcomes by alleviating pain severity, reducing opioid consumption, and cutting down healthcare costs. Further research and clinical integration of these techniques is imperative to enhance pain management protocols in trauma centers.

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Randomized comparative study between two different techniques of intercostobrachial nerve block together with brachial plexus block during superficialization of arteriovenous fistula

Abstract: ICBNB proximal approach provides a high success rate with less amount of rescue analgesia compared to the distal approach.

Cited by 14 publications

References 13 publications

Blockade of intercostobrachial nerve by an erector spinae plane block at T2 level: a case report

Blockade of intercostobrachial nerve by an erector spinae plane block at T2 level: a case report

Beyond the Brachial Plexus: Reapplication of the Thoracic Paravertebral Block for Upper Arm Fistula Surgery

Advancing pain management for extremity trauma: the evolution of ultrasound-guided nerve blocks for patients in the supine position in trauma centers

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