Axillary serratus anterior plane block as a novel approach to anesthetizing the intercostobrachial nerve for upper arm arteriovenous fistula creation surgery-three case reports.

IF 4.2 4区医学 Q1 ANESTHESIOLOGY

Korean Journal of Anesthesiology Pub Date : 2025-03-06 DOI:10.4097/kja.24893

Chi Ho Chan, Jia Yin Lim, Abey M V Mathews

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Abstract

Background: Current regional anesthesia techniques used to anesthetize the intercostobrachial nerve (ICBN) for upper arm surgery either lack reliability or have increased procedural risks. Safer and more reliable regional anesthetic techniques are required to block the ICBN effectively. Here, we introduce a novel "axillary serratus anterior plane (A-SAP) block" for anesthetizing the ICBN to allow surgical anesthesia for upper arm arteriovenous fistula (UA-AVF) creation.

Case: We present three cases involving a 79-year-old Chinese male, a 73-year-old Malay female, and a 38-year-old Chinese male, in which the A-SAP block was utilized in UA-AVF creation surgeries. In all three cases, the A-SAP block was performed in combination with a supraclavicular brachial plexus block. None of the patients required local anesthetic supplementation intraoperatively.

Conclusions: The A-SAP block reliably and safely anesthetized the ICBN for UA-AVF creation surgery and is a reliable alternative to higher-risk block techniques, such as paravertebral block or neuraxial block.

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腋锯肌前平面阻滞作为上臂动静脉造瘘术中肋间臂神经麻醉的新方法——附3例报告。

背景：目前用于上臂手术肋间臂神经（ICBN）麻醉的区域麻醉技术要么缺乏可靠性，要么增加了手术风险。为了有效阻断ICBN，需要更安全、更可靠的区域麻醉技术。在这里，我们介绍了一种新的“腋锯肌前平面（a - sap）阻滞”用于麻醉ICBN，以允许手术麻醉上臂动静脉瘘（UA-AVF）的产生。病例：我们报告了3例患者，分别为一名79岁的中国男性、一名73岁的马来女性和一名38岁的中国男性，其中a - sap阻滞用于UA-AVF创造手术。在所有三个病例中，a - sap阻滞联合锁骨上臂丛阻滞。术中无患者需要补充局麻。结论：a - sap阻滞可靠、安全地麻醉了用于UA-AVF形成手术的ICBN，是一种可靠的替代高风险阻滞技术，如椎旁阻滞或神经轴阻滞。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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