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.
Department of Anaesthesiology, Berufsgenossenschaftliche Unfallklinik, Murnau, Germany
Correspondence to Johannes Büttner, Department of Anaesthesiology, Berufsgenossenschaftliche Unfallklinik, Professor-Küntscher-Straße 8, D-82418 Murnau, Germany