Ultrasound and neurostimulation-guided axillary brachial plexus block for resection of a hemodialysis fistula aneurysm.

Abstract

An ASA III patient presenting with a voluminous hemodialysis fistula aneurysm at the elbow was scheduled for its resection. Axillary brachial plexus block was performed under ultrasound and neurostimulation guidance. Despite unexpected nerve positions in relation to pathological vascular anatomy, this combined approach resulted in an adequate block with a low volume of local anesthetic, without obvious vascular puncture or intraneural injection.