Ultrasound-guided block of the axillary nerve: a volunteer study of a new method

Abstract

We describe a new ultrasound-guided technique to specifically block the axillary nerve. The potential clinical role of this new block remains to be determined.

Selective Suprascapular and Axillary Nerve Block Versus Interscalene Plexus Block for Pain Control After Arthroscopic Shoulder Surgery

“…The sensory innervation of the shoulder originates primarily from the AN and SSN but may also involve limited contributions from the subscapular nerves (C5 and C6), the lateral pectoral nerves (C5, C6, and C7), and the musculocutaneous nerves (C5, C6, and C7). 17,23,24 We speculate that absent blockade of these nerves, combined with a relatively high rate of incomplete SSN and AN blocks, could explain why SSB provided inferior analgesia during the initial postoperative period. Our findings echo those of previous trials.…”

“…Axillary nerve blocks were performed using the technique described by Rothe et al 17 The ultrasound transducer was placed in a sagittal plane over the humeral head on the posterior aspect of the arm in order to identify the following structures: the deltoid muscle overlying the surgical neck of the humerus, the teres minor muscle, the posterior circumflex humeral artery, and the lateral head of the triceps brachii muscle. The AN runs through the quadrangular space (foramen humerotricipitale) accompanied by the posterior circumflex humeral vein and artery.…”

Distal infrared thermography and skin temperature after ultrasound-guided interscalene brachial plexus block

“…Selective block of either the musculocutaneous or radial nerve had been shown not to increase Ts in the forearm. 6 Furthermore, in a study wherein we selectively blocked the axillary nerve, 12 we could not detect any change in Ts in the area innervated by the axillary nerve measured by infrared thermography (unpublished data). We therefore defined specific areas of interest (AOI) according to Fig.…”

Ultrasonography and Ultrasound-guided Interventions of the Shoulder

“…When the axillary nerve reaches the surgical neck it move posteriorly together with the posterior humeral circumflex artery; the area where the nerve contacts the surgical neck is the site of blockade. When Rothe et al 23) performed an axillary nerve block, they inserted a needle from the proximal side of the probe on a sitting patient; in comparison, authors performed axillary nerve blocks with the patient in a lateral decubitus position and the arm in slight internal rotation for the stability during the procedure. We examined the teres minor muscle and the surgical neck of the humerus in the longitudinal plane by placing the probe around 2 cm inferior to the acromial posterior angle and in parallel to the long axis of the humeral shaft.…”

“…The axillary nerve can be blocked when pain is not resolved with suprascapular nerve block. 23,24) The axillary nerve originates from the 5th and the 6th cervical roots and branches from the posterior cord of the brachial plexus. It traverses to the posterior direction through the quadrangular space which is between the teres minor and teres major muscles.…”