Axillary nerve: what anesthesiologists and pain physicians should know

Area of Science:

• Anatomy and physiology
• Regional anesthesia
• Pain management

Background:

• Shoulder joint innervation is complex and not fully understood by pain specialists.
• The axillary nerve's role in shoulder innervation and its blockade for pain management is recognized but incompletely described.
• A comprehensive understanding of the axillary nerve's course and sonoanatomy for interventions is lacking in current literature.

Purpose of the Study:

• To provide a detailed discussion of the functional anatomy of the axillary nerve concerning shoulder joint innervation.
• To describe the sonoanatomy and identify optimal targets for axillary nerve blockade in pain interventions.
• To enhance understanding of the axillary nerve's contribution to shoulder pain and stimulate future research.

Main Methods:

• Detailed review of functional anatomy of the axillary nerve.
• Description of sonographic identification of potential intervention windows.
• Discussion of the axillary nerve's contribution, extent, and type of shoulder joint innervation.

Main Results:

• The article elucidates the often-misunderstood innervation patterns of the axillary nerve to the shoulder joint.
• It details the anatomical course and relevant sonoanatomy for targeting the axillary nerve.
• Potential sonoanatomic windows for axillary nerve intervention are identified and discussed.

Conclusions:

• A clearer understanding of axillary nerve anatomy and sonoanatomy is crucial for effective shoulder pain management.
• This educational review aims to improve regional anesthesiologists' and pain specialists' knowledge of axillary nerve blockade.
• Further research is needed to explore the full potential of axillary nerve interventions for chronic and perioperative shoulder pain.