title: Ultrasound imaging accurately identifies the intercostobrachial nerve.
abstract: OBJECTIVE
  To test the hypothesis that identification and blockade of the intercostobrachial nerve (ICBN) can be achieved under ultrasound (US) guidance using a small volume of local anesthetic.
  
  
  METHODS
  Twenty-eight adult male volunteers were examined at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia from November 2012 to September 2013. Intercostobrachial nerve blockade was performed using one ml of 2% lidocaine under US guidance. A sensory map of the blocked area was developed relative to the medial aspect of the humeral head.
  
  
  RESULTS
  The ICBN appears as a hyper-echoic structure. The nerve diameter was 2.3±0.28 mm, and the depth was 9±0.28 mm. The measurements of the sensory-blocked area relative to the medial aspect of the humeral head were as follows: 6.3±1.6 cm anteriorly; 6.2±2.9 cm posteriorly; 9.4±2.9 cm proximally; and 9.2±4.4 cm distally. Intercostobrachial nerve blockade using one ml of local anesthetic was successful in all cases.
  
  
  CONCLUSIONS
  The present study described the sonographic anatomical details of the ICBN and its sensory distribution to successfully perform selective US-guided ICBN blockade.
authors.affiliation: Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail. athallaj@yahoo.com.
authors.forename: Ahmed K
authors.initials: AK
authors.lastname: Thallaj
authors.forename: Mohammad K
authors.initials: MK
authors.lastname: Al Harbi
authors.forename: Tariq A
authors.initials: TA
authors.lastname: Alzahrani
authors.forename: Salah N
authors.initials: SN
authors.lastname: El-Tallawy
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Alsaif
authors.forename: Mohannad
authors.initials: M
authors.lastname: Alnajjar
mesh_terms: D000328:Adult; D000779:Anesthetics, Local; D005240:Feasibility Studies; D064368:Healthy Volunteers; D006801:Humans; D007367:Intercostal Nerves / Q000000981:diagnostic imaging*; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine