الفهرس 
Introduction about Virtual Cadaveric LaboratoryOnly 14 pages are availabe for public view
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Abstract
Midhumeral block using ultrasound guidance involves blocking each of the four nerves (radial, ulnar, median and musclocutaneous) separately at the humeral canal, at the level of the junction between the proximal one third and distal two thirds of the humerus. This procedure is indicated for surgeries in the elbow, forearm and hand, also can be used as a supplementation of incomplete anesthesia of the brachial plexus. The humeral canal, containing the terminal nerves of the brachial plexus and the brachial artery, it lies on the medial aspect of the arm. At this location it is possible to anesthetize the four major nerves of the upper limb separately. The main landmark for ultrasound probe position can be approximated as three fingers’ breadth below the anterior axillary fold but, the nerves of the brachial plexus do not appear together on the same ultrasound screen at this level. As well as, their relation to blood vessels is less variable than at the axillary level. Consequently, blockade of these nerves with the classical single point of needle puncture is technically difficult.
Conclusion: Midhumeral block has been reported higher success rate than the traditional axillary brachial plexus block, whereas the onset of complete sensory block was shorter in the axillary approach, with no difference in the time to complete both techniques.
Keywords: Midhumeral block; Peripheral nerve blocks.
References
Herman A, Yadagiri M, Macrosson D and MajeedA (2015):Pennine Acute Hospitals NHS Trust, Oldham, UK. Anesthesiology and Pain Medicine; p 365 -380.
Carlos G and Fabián A (2008): Brachial plexus terminal nerve block in the humeral canal (“midhumeral block”), 10(3): 115–122.