What is an axillary block?
The axillary block is a peripheral nerve block performed in the axilla and anesthetizes the terminal branches of the brachial plexus (figure 1). Axillary blocks are used for anesthesia and/or analgesia for surgery of forearm, wrist, hand, and fingers.
Is axillary block painful?
The axillary block is a very safe and effective method for providing surgical anesthesia for the upper extremity. The numbness and heaviness lasts from 4 to 18 hours, depending on the medicines used. Most patients will have a bruise in their armpit which is painful to touch for a few days.
Which nerve is spared in axillary block?
The axillary block aims to block the terminal branches of the brachial plexus which include the median, ulnar, radial and musculocutaneous nerves. The musculocutaneous nerve often departs from the lateral cord in the proximal axilla and is commonly spared by the axillary approach.
Does an axillary block cover the elbow?
However, axillary block is usually not recommended for surgery about the elbow because blockade at this level may result in inadequate block of the terminal nerves that arise from the medial, posterior, and lateral cords, and provide sensory innervation to the upper arm.
How is an arm block done?
It involves the careful injection of local anaesthetic around the nerves that provide sensation to this area to make them numb for surgery. The injection can be in your neck, around your collar bone or armpit or further down your arm.
What is an axillary ultrasound?
Diagnostic breast and axilla ultrasounds produce images show abnormalities within the breast and armpit (axilla). More specifically, this form of imaging examines the concentration of lymph nodes in your armpit, looking for irregularities and helping identify abnormal axillary sentinel lymph nodes.
How long does arm block last?
The nerve block can last up to 24 hours. During this time: It is important to protect your shoulder, arm and hand from injury. You cannot control shoulder, arm or hand movement until the nerve block wears off.
Is the axillary vein in the axillary sheath?
The structures traversing the apex of the axilla are grouped into a neurovascular bundle. However, the axillary vein (as well as lymphatics and lymph nodes) is outside the axillary sheath, providing room for it to expand. …
What is a Suprascapular nerve block?
A suprascapular nerve block is an injection of a local anesthetic and steroid to block the nerves that influence pain in the shoulder.
How do I make an axillary block?
The axillary artery is palpated and stabilized using a two-finger palpation technique. As the needle is advanced toward the pulse of the axillary artery, bright red arterial blood is aspirated. A thin, long beveled needle (typically 1.5-in., 25-gauge) is used to minimize the risk of axillary hematoma.
What are the contents of axilla?
The main contents of the axilla are the axillary vein and artery, the axillary lymph nodes, with a portion of the brachial plexus and its branches. Brachial plexus – a complex network of nerves formed by the lower cervical and upper thoracic ventral nerve roots, which begins in the neck and extends into the axilla.
What is a shoulder block?
The shoulder block is an alternative analgesic technique to the interscalene or supraclavicular brachial plexus blocks that avoid the motor block of the arm and hand and the phrenic nerve (hemidiaphragmatic paresis).
When do you ask for an axillary block?
Surgeons often request an axillary block for their patients when the planned operation involves the hand, wrist, forearm, or elbow. Before the axillary injection is performed, your anesthesiologist will provide some sedation through your intravenous line. Most likely, you won’t even remember the axillary injection.
What kind of anesthetic is used for an axillary block?
Press the artery into the humerus near the axillary skin crease, and inject a 4-5 cc of local anesthetic (will block the intercostobrachial nerve, potentially decreasing tourniquet pain). Traditional techniques include nerve stimulation as well as transarterial techniques (40-50 cc posterior to the artery).
What kind of nerves are blocked by the axillary block?
The axillary technique reliably blocks the ulnar, median, and radial nerves (but not the musculocutaneous and the intercostobrachial nerves which leave the brachial plexus at the level of the coracoid process).
How many injections are needed to block the axillary artery?
Axillary block can be accomplished by two to four separate injections, depending on the disposition of the nerves around the axillary artery (AA) and the quality of the image. MCN, musculocutaneous nerve; MN, median nerve; RN, radial nerve; UN, ulnar nerve.