img
Ultrasound anatomy of the brachial plexus nerves in the neurovascular bundle at the axilla in patients undergoing upper-extremity block anesthesia      
Yazarlar
Evren Üstüner
Ankara Üniversitesi, Türkiye
Doç. Dr. Ayşe YILMAZ
Türkiye
Güngör Enver Özgencil
Ankara Üniversitesi, Türkiye
Fatma Feyhan Ökten
Ankara Üniversitesi, Türkiye
Keziban Sanem Çakar Turhan
Ankara Üniversitesi, Türkiye
Özet
Purpose: Familiarity with the localization of the nerves in the neurovascular bundle that constitutes the axillary segment of the brachial plexus (BP) is important when applying ultrasound (US)-guided block anesthesia. Therefore in this study we aimed to delineate the anatomy of the median, radial, and ulnar nerves of the BP at the axilla with US and electrical stimulation. Materials and methods: The study included 60 patients who were scheduled to undergo upper-arm surgery with axillary block anesthesia. Prior to anesthesia, ulnar, radial, and median nerves were localized with US using a 12-h quadrant identification system that placed the axillary artery (AA) in the middle. The nerves were then functionally tested using a neurostimulator. Results: The radial nerve was mainly located in the 4-6 o'clock arc (posterior and posteromedial to AA) in 50 (83 %) of patients. Ulnar nerve was mainly at the 12-3 o'clock arc (anteromedial to AA) in 51 (85 %) of patients. Ulnar nerve showed a second peak at 9-10 o'clock quadrant (anterolateral to AA) in 11 % (7) of patients. Median nerve location was most common in the 12 and 9 o'clock arc (anterior and anterolateral to AA) in 53 (88 %) of the patients. Conclusions: Ultrasound is a useful tool for depicting BP anatomy in the axillary fossa prior to block anesthesia. Median, ulnar, and radial nerves form a highly consistent triangular pattern around the axillary artery that is easily recognizable with US. © 2013 ISS.
Anahtar Kelimeler
Axilla block anesthesia | Brachial plexus | Electrical stimulation | Ultrasound
Makale Türü Özgün Makale
Makale Alt Türü SCOPUS dergilerinde yayımlanan tam makale
Dergi Adı SKELETAL RADIOLOGY
Dergi ISSN 0364-2348
Dergi Tarandığı Indeksler EBSCO, EMBASE, SCOPUS
Makale Dili İngilizce
Basım Tarihi 05-2013
Cilt No 42
Sayı 5
Sayfalar 707 / 713
Doi Numarası 10.1007/s00256-013-1578-7
Makale Linki http://dx.doi.org/10.1007/s00256-013-1578-7