Axillary and midhumeral approach for plexus block

Many variations of the axillary approach for blocking of the brachial plexus have been described. The axillary approach tends to be the technique with the lowest risk of serious complications; in particular, there is no risk of pneumothorax. A fairly high failure rate and an onset time of 20-40 minutes is why this technique, first described by Hirschel in 1911, is still discussed. Ideally, axillary brachial plexus blockade would be achieved using a technique that was easy and quick to perform with a fast onset time, a 100% success rate and without any risk for the patient; but, as all studies show, this goal is still far away.