axillary brachial plexus block腋窝臂神经丛块.pdfVIP

Hindawi Publishing Corporation Anesthesiology Research and Practice Volume 2011, Article ID 173796, 5 pages doi:10.1155/2011/173796 Review Article Axillary Brachial Plexus Block Ashish R. Satapathy and David M. Coventry Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK Correspondence should be addressed to David M. Coventry, david.coventry@ Received 23 December 2010; Accepted 13 March 2011 Academic Editor: Sridhar Kollipara Copyright © 2011 A. R. Satapathy and D. M. Coventry. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The axillary approach to brachial plexus blockade provides satisfactory anaesthesia for elbow, forearm, and hand surgery and also provides reliable cutaneous anaesthesia of the inner upper arm including the medial cutaneous nerve of arm and intercostobrachial nerve, areas often missed with other approaches. In addition, the axillary approach remains the safest of the four main options, as it does not risk blockade of the phrenic nerve, nor does it have the potential to cause pneumothorax, making it an ideal option for day case surgery. Historically, single-injection techniques have not provided reliable blockade in the musculocutaneous and radial nerve territories, but success rates have greatly improved with multiple-injection techniques whether using nerve stimulation or ultrasound guidance. Complete, reliable, rapid, and safe blockade of the arm is now achievable, and the paper summarizes the current position with particular reference to ultrasound guidance. 1. Introduction of the arm,