Ultrasound may provide effective guidance during nerve blocks in cases where nerve stimulation is not feasible for various reasons. We describe a 28-year-old, ASA physical status I, male patient who was operated for pectoral flap release under lateral sagittal infraclavicular block. Using ultrasound guidance alone, total volume of 30 ml of local anesthetic mixture (15 ml of levobupivacaine 5 mg...

BACKGROUND The aim of this study was to quantify the length of the axillary nerve that is able to be dissected through a standard anterior (deltopectoral) and posterior approach. The authors hypothesize that a segment of the axillary nerve cannot be reached using both approaches simultaneously. METHODS Axillary nerves of five frozen cadavers were dissected using an anterior and posterior appr...

BACKGROUND The axillary nerve may be injured during percutaneous fixation of proximal humerus fractures. This study investigated the kinematic behavior of the superior and inferior borders of the axillary nerve under varying shoulder positions. This information may reduce iatrogenic neurologic injury during fracture reduction and hardware placement. METHODS The lateral deltoid approach was pe...

Methods. We enrolled 19 ASA I–II patients undergoing hand or forearm surgery. The four nerves of the axillary plexus were identified with ultrasound guidance. Lidocaine 1.5% with epinephrine 1:200 000 was loaded into a syringe driver. A 22 G needle was inserted in the long axis to each nerve and injection commenced using the bolus function (600 ml h). The needle was repositioned until the nerve...

BACKGROUND The most common neurological defect in traumatic anterior glenohumeral dislocation is isolated axillary nerve palsy. Most recover spontaneously; however, some have persistent axillary neuropathy. An intact rotator cuff may compensate for an isolated axillary nerve injury; however, given the high rate of rotator cuff pathology with advancing age, patients with an axillary nerve injury...

BACKGROUND AND OBJECTIVES The axillary artery is the anatomical reference, in the surface, for axillary brachial plexus block. Anatomic studies suggest variability in the location of the structures in the brachial plexus in relation to the axillary artery. These variations can hinder blocks by neurostimulation. The ultrasound allows the identification of the structures within the brachial plexu...

BACKGROUND In an axillary brachial plexus block (ABPB), where relatively large doses of local anesthetics are administered, levobupivacaine is preferred due to a greater margin of safety. However, the efficacy of levobupivacaine in ABPB has not been studied much. We performed a prospective, double-blinded study to compare the clinical effect of 0.375% levobupivacaine with 0.5% levobupivacaine f...

Breast cancer surgery frequently involves an axillary clearance procedure for nodal metastases. Injury to the thoracodorsal nerve is one of the complications related to the axillary dissection. The thoracodorsal nerve innervates the latissimus dorsi muscle which facilitates in certain movements of the arm. Moreover, it can be used as a nerve graft in long thoracic nerve injury whether in trauma...