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Ultrasound-Guided Musculocutaneous Nerve Block: A Description of a Novel Technique
  1. Brian C. Spence, M.D.,
  2. Brian D. Sites, M.D. and
  3. Mike L. Beach, M.D., Ph.D.
  1. From the Department of Anesthesiology, Dartmouth Medical School, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
  1. Reprint requests: Brian C. Spence, M.D., Assistant Professor of Anesthesiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, New Hampshire, 03756. E-mail: brian.c.spence{at}


Background and Objective: Localizing the musculocutaneous nerve for neural blockade is crucial to providing surgical anesthesia for the distal forearm. We present a novel approach for localizing and anesthetizing the musculocutaneous nerve.

Case Reports: Ten patients underwent successful ultrasound-guided musculocutaneous nerve blocks. In this technique, either a 10-MHz or a 12-MHz linear probe was placed at the junction of the pectoralis major muscle and the biceps muscle such that the axillary artery was visualized in cross section. The probe was moved towards the biceps muscle until the musculocutaneous nerve was visualized lying between the coracobrachialis and biceps muscles. A 22-gauge, 50-mm b-bevel needle was inserted under direct vision until the needle was adjacent to the nerve. Local anesthetic was then injected, which generated surgical anesthetic conditions in all patients.

Conclusion: Ultrasound can facilitate the localization and local anesthetic block of the musculocutaneous nerve.

  • Nerve block
  • Musculocutaneous nerve
  • Ultrasound
  • New technique

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