Lateral antebrachial cutaneous nerve injury as a complication of phlebotomy

The lateral antebrachial cutaneous nerve may be injured by attempts at cephalic vein venipuncture because of its anatomic location under the cephalic vein. Multiple attempts at venipuncture using plunging-type action should be avoided. Electric dysesthesias during venipuncture should alert the phlebotomist to possible nerve damage. Primary repair of the injured nerve or its fascicles may be hindered by tension across the antecubital fossa when the elbow is in extension or by the presence of the biceps tendon. As an alternative surgical solution, the neuroma may be resected and the proximal end buried within the substance of the brachialis muscle.