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Axillary blocks


Axillary blocks

  • Consent and versed
  • Arm at 90 degree angle
  • Palpate artery high in the armpit
  • Second finger and middle finger of left hand should straddle artery, with left hand parallel to arm\
  • Hold gentle pressure to stabilize artery and tissue
  • Small amount of local over site
  • Approach at 45 degrees, going over the two fingers of the left hand
  • Use Stimuplex needle with setting at 1 mA
  • With stimulator to 0.4 mA, or arterial puncture, or paresthesia, give 40 ml of 1.5% mepivacaine with 1 ml of HCO3 and 1:200,000 epinephrine (if artery is punctured, advance the needle until blood can no longer be aspirated)
  • Using same site, inject 5 ml subcutaneous local, aiming toward the feet for tourniquet pain
  • Identify groove between biceps and brachialis, go in with Stimuplex at 1 mA and give 5 ml to block musculocutaneous nerve.

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