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» Articles » PMID: 26446339

Ultrasound Imaging Accurately Identifies the Intercostobrachial Nerve

Overview
Journal Saudi Med J
Specialty General Medicine
Date 2015 Oct 9
PMID 26446339
Citations 5
Authors
Ahmed K Thallaj
Mohammad K Al Harbi
Tariq A Alzahrani
Salah N El-Tallawy
Abdulaziz A Alsaif
Mohannad Alnajjar
Affiliations
Soon will be listed here.
Abstract

Objective: To test the hypothesis that identification and blockade of the intercostobrachial nerve (ICBN) can be achieved under ultrasound (US) guidance using a small volume of local anesthetic.

Methods: Twenty-eight adult male volunteers were examined at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from November 2012 to September 2013. Intercostobrachial nerve blockade was performed using one ml of 2% lidocaine under US guidance. A sensory map of the blocked area was developed relative to the medial aspect of the humeral head.

Results: The ICBN appears as a hyper-echoic structure. The nerve diameter was 2.3±0.28 mm, and the depth was 9±0.28 mm. The measurements of the sensory-blocked area relative to the medial aspect of the humeral head were as follows: 6.3±1.6 cm anteriorly; 6.2±2.9 cm posteriorly; 9.4±2.9 cm proximally; and 9.2±4.4 cm distally. Intercostobrachial nerve blockade using one ml of local anesthetic was successful in all cases.

Conclusion: The present study described the sonographic anatomical details of the ICBN and its sensory distribution to successfully perform selective US-guided ICBN blockade.

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Comparison of the Effect of Intercostobrachial Nerve Block with and Without Ultrasound Guidance on Tourniquet Pain After Axillary Block of Brachial Plexus: A Randomized Clinical Trial.

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Combinations of nerve blocks in surgery for post COVID-19 pulmonary sequelae patient: A case report and review of literature.

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Ultrasound to the Rescue: Axillary Clearance under Complete Regional Blockade.

Munasinghe B, Subramaniam N, Nimalan S, Sivamayuran P Case Rep Anesthesiol. 2021; 2021:6655930.

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Ultrasound Imaging for the Cutaneous Nerves of the Extremities and Relevant Entrapment Syndromes: From Anatomy to Clinical Implications.

Chang K, Mezian K, Nanka O, Wu W, Lou Y, Wang J J Clin Med. 2018; 7(11).

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References
1.
Andersen K, Aasvang E, Kroman N, Kehlet H . Intercostobrachial nerve handling and pain after axillary lymph node dissection for breast cancer. Acta Anaesthesiol Scand. 2014; 58(10):1240-8. DOI: 10.1111/aas.12393. View
2.
Wijayasinghe N, Andersen K, Kehlet H . Neural blockade for persistent pain after breast cancer surgery. Reg Anesth Pain Med. 2014; 39(4):272-8. DOI: 10.1097/AAP.0000000000000101. View
3.
Loukas M, Hullett J, Louis Jr R, Holdman S, Holdman D . The gross anatomy of the extrathoracic course of the intercostobrachial nerve. Clin Anat. 2006; 19(2):106-11. DOI: 10.1002/ca.20226. View
4.
Thallaj A, Marhofer P, Moriggl B, Delvi B, Kettner S, Almajed M . Great auricular nerve blockade using high resolution ultrasound: a volunteer study. Anaesthesia. 2010; 65(8):836-40. DOI: 10.1111/j.1365-2044.2010.06443.x. View
5.
Thallaj A, Marhofer P, Kettner S, Al-Majed M, Al-Ahaideb A, Moriggl B . High-resolution ultrasound accurately identifies the medial antebrachial cutaneous nerve at the midarm level: a clinical anatomic study. Reg Anesth Pain Med. 2011; 36(5):499-501. DOI: 10.1097/AAP.0b013e318228a359. View