Axillary arteries are forgiving things...
Have once been advised by an aneasthetist that he actually aims for the
artery, to go through and come out the other side, still within the sheath,
as a guarantee of injecting into the sheath. I don't recommend this.
Use a very fine needle (I prefer butterfly). Try to slide either side of the
vessel. If, while pushing through, you acccidentally draw an ABG sample -
don't panic, but push through to the other side, do your injecting and pull
out. But best not to go into the vessel in the first place. Have seen it
happen a lot less than I have seen neck "central lines" go into a carotid,
and most people use a much bigger needle to "scout" for the jugular than is
used for an axillary block.
However, must accept the chance of failure on the radial nerve, hence my
previously stated certain degree of failure. I find it strange that,
althought I find the axillary block much sexier, I too have had less
failures with a haematoma block (i.e. NONE), while I estimate I fail every
10th or so Axillary block.
As for Prilocaine S/E's - can't say, as I never use it.
>From: [log in to unmask] (Rowley Cottingham)
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>Subject: Re: VT and acidosis
>Date: Thu, 2 Mar 2000 06:11 +0000 (GMT Standard Time)
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>Axillary nerve block. The perfect thing if you don't want the radial nerve
>blocked or you want a perforated axillary artery. In fact
>doing both is quite possible.
>
>
>I'm baffled by the assumed link between prilocaine and cardiac arrhythmia.
>Go on, find me a paper describing it.
>
>
>Best wishes,
>
>
>Rowley Cottingham
>
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