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EP039 Ultrasound guided forearm nerve blocks: a cadaveric injection study
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EP039 Ultrasound guided forearm nerve blocks: a cadaveric injection study
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Journal Article
EP039 Ultrasound guided forearm nerve blocks: a cadaveric injection study
2025
Overview
Background and AimsBlocks of the individual nerves in the forearm is well established, but data regarding the spread of local anesthetics is scarce/infrequent. Based on the cadaveric injection of latex in the following nerves- Median (MN), Ulnar (UN), and Superficial radial The primary aim was to evaluate the latex spread, circumferential or non-circumferential. The secondary aim was to investigate the dye diffusion in muscles, paraneural, epineural tissue, longitudinal spread along the nerve, and anatomic barriers.MethodsWith 6 soft embalmed cadavers (12 specimens), a total of 36 injections were performed. At a point, 5 cm from the elbow crease 1) 5 ml of blue latex was injected in close vicinity of the MN. 2) 5 ml of green latex was injected between the ulnar artery and the UN. 3) 5 ml of green latex was injected close to the SRN. After injection, all specimens were dissected, and the three nerves were traced from the elbow crease to the wrist joint.ResultsThe blue latex disintegrated into various thin bands, though remaining in the same plane of FDP and FDS in the close vicinity of the median nerve. Beneath the brachioradialis and superficial to ECRL, a greenish discoloration was observed, which encroached upon the bicipital aponeurosis. The superficial radial nerve was engulfed significantly than the deep radial nerve. 9 figures 1,2,3) Deep to the flexor carpi ulnaris (FCU), the green latex spread linearly along the ulnar nerve and the ulnar artery.ConclusionsBased on our cadaveric injection study, we recommend a forearm nerve block at ‘5 cm’ distal to the elbow crease. We conclude that in the forearm nerves, a non-circumferential, longitudinal spread pattern is consistent with a ‘3 ml’ latex injection. The lateral antebrachial cutaneous and the medial cutaneous nerves of the forearm were spared and would require separate injections.Abstract EP039 Figure 1Median nerve dissection in a cadaver[Image Omitted. See PDF.]Abstract EP039 Figure 2Radial nerve dissection in a cadaver[Image Omitted. See PDF.]Abstract EP039 Figure 3Ulnar nerve dissection in cadaver[Image Omitted. See PDF.]
Publisher
BMJ Publishing Group LTD
Subject
