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What is Axillary Nerve Block?
Axillary nerve block involves the reversible loss of
sensation of the axillary nerve area through the application
of a local anesthetic.
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Effects of Axillary Nerve Block
The
axillary nerve block mainly provides temporary pain control.
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Candidates for Axillary Nerve Block
It is
a well-established practice that nerve blocks are used for
diagnostic, therapeutic, prognostic and treatment of chronic
pain. Nowadays, axillary nerve blocks are frequently used
for emergency and elective upper limb surgery since this
method gives reliable anesthesia with less complications.
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Your
Consultation
A
patient can undergo nerve block therapy only after an
accurate diagnosis of the source of the pain is made. The
patient will have to go through a thorough examination that
may include a complete medical history, physical
examination, laboratory studies, and a complete psychiatric
and psychosomatic assessment.
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The Axillary Nerve Block
Procedure
Initially, the axillary artery is palpated at its most
proximal point in the axilla along the line of the humerus.
Then a few milliliters of 1% lignocaine are injected to
anesthetize the skin at this point. After that, a tourniquet
is applied distal to this area and is inflated to ensure
that the local anesthetic tracks up the brachial plexus.
Then
after a few minutes, a needle is passed slightly superior to
the axillary artery. And paraesthesia is felt on progressing
to the depth of the axillary nerve. Aspiration is needed to
ensure that the needle is not in the vessel. The local
anesthetic is then injected (up to 40 ml of 1% lignocaine
with adrenaline). And finally, the cuff is deflated a few
minutes later.
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Recovery
The
nerve blocks may relieve pain from several hours up to
several months. In a lot of cases, these blocks are
performed in combination with a rehabilitation program and
can give the opportunity to proceed with an effective
rehabilitation.
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Risks
An
axillary nerve block can be applied before the correction of
fractures distally in the arm. However, the procedure
includes possible complications such as neuropraxia,
intravascular injection and the dissemination of malignancy.
Axillary blocks are not recommended for above the elbow
procedures.
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Frequently Asked
Questions
Q:
What is a nerve block?
A:
A nerve block involves the injection of a local anesthetic
or a neurolytic agent into or near a peripheral nerve, a
sympathetic nerve plexus or a local pain-sensitive trigger
point
Q:
What is the purpose of an axillary nerve block?
A:
The axillary
nerve block is a safe and reliable way of giving anesthesia
to the upper extremity. It is beneficial in cases of
traumatic injury where application of general anesthesia
might be hazardous. The use of a large volume of anesthetic
is essential, especially when it is important to block the
musculocutaneous or axillary nerve.
Q: Who
can be helped by nerve blocks?
A:
Nerve
blocks are recommended for those who suffer from neck pain,
low back pain, sciatica resulting from herniated discs,
lumbar canal stenosis, complex regional pain syndrome
(reflex sympathetic dystrophy), pain arising from peripheral
vascular disease, shingles pain, myofascial pain syndrome
and cancer pain.
Q: How
does a nerve block work?
A:
A
nerve block can alleviate pain by using a local anesthetic
to interrupt pain sensory pathways and preventing them from
reaching the brain.
Q:
When should a nerve block not be performed?
A:
Patients who are on anticoagulant therapy with heparin or
coumadin should not undergo a nerve block procedure. These
particular medications can increase the risk of bleeding.
Also, nerve blocks should not be performed on patients who
have an active infection around the area of pain or on those
who are allergic to local anesthetics or steroids.
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