Regional - Upper Arm Blocks
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- anesthesia/analgesia to the to the arm, elbow, forearm, and hand. It should be noted that the unshaded areas are not covered
Patient Position and Landmarks?
- Patient is in the supine position with the head facing away from the side to be blocked. The arm on the side of the block placement should be abducted and form a roughly 90o angle in the elbow joint.
- Landmark is Axillary artery pulse, Coracobrachialis muscle and Pectoralis major muscle
Nerve stimulator technique and look for a single nerve response, (hand twitch at 0.2-0.4 mA current output indicates corect placement and stimulation of the median, radial, or ulnar nerves)
Which nerve is not consistently blocked and what does it supply?
Musculocutaneous N. - as it leaves the brachial plexus sheath proximally
- Supplies large area and is important in achieving complete anesthesia of the forearm and biceps.
- Supplies biceps and brachialis. The
- nerve continues distally as the lateral cutaneous nerve of the forearm.
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