Accidental intraneural injection into the musculocutaneous nerve visualized with ultrasound

Ultrasound has become a widely used tool within the practice of regional anesthesia, offering real-time visualization of the nerves, needle, and local anesthetic during performance of a block. A successful ultrasound-guided axillary block was performed on a healthy adult male undergoing wrist surgery. Postoperative review of the ultrasound video recording of the block suggested that an intraneural injection had occurred during the procedure. The patient had an effective block and suffered no adverse neurological effects. Recording and reviewing ultrasound images of a regional block can be important for documentation and educational purposes.