Selective ulnar nerve localization is not essential for axillary brachial plexus block using a multiple nerve stimulation technique

Abstract

A triple-injection method of axillary block in which the ulnar nerve was not purposely located provides a spread and a latency of sensory block equal to that obtained with a 4-injection technique. A shorter performance time is an advantage of this approach.

A Comparison Between Ultrasound-Guided Infraclavicular Block Using the “Double Bubble” Sign and Neurostimulation-Guided Axillary Block

“…2 Using the same mixture as for ICB, 14, 14, and 7 mL were injected to anesthetize the median, radial, and musculocutaneous nerves, respectively.…”

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

“…Multiple nerve stimulation axillary block is a wellestablished technique that is associated with a high success rate of anesthesia of the upper limb at or below the elbow [2][3][4][5][6]. However, multiple nerve stimulation requires a longer time to complete and has a potentially higher risk of developing postanesthetic nerve injury [7].…”

Transarterial block as an addition to a conventional catheter technique improves the axillary block

“…Sia et al found comparably high success rates of 90% and 92% for successful blocks of the ulnar nerve in a nerve stimulator guided study on AXB with multiple injections. 49 The authors could also demonstrate that a selective block of the ulnar nerve in one of the study groups did not increase the block success rate. Tran et al had comparable success rates in ultrasound guided double-, triple-and quadruple-injection techniques and did not achieve higher success rates for the ulnar nerve when it was selectively blocked.…”