PMC6830355_01
Approximate site of injection for local block and treatment line for cryoablation of intercostobrachial nerve (dotted line).. Note: This image is not the actual patient in the case report.
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The area was prepped with a chlorhexidine solution and a 25-gauge needle was used to deposit local anesthetic solution just distal to the axillary fossa, from the deltoid muscle toward the triceps muscle along the anatomic localization of the ICBN (Figure 1). The device was used on the dotted line shown in Figure 1, moving circumferentially to cover the entire cross-section of the ICBN.
A 3-pronged cryoablation device (with three 27-g needles, approximately 7.6 mm in length) was used along the treatment line shown in Figure 1, moving circumferentially to cover the entire cross-section of the ICBN. Multiple cycles of cryotherapy lasting 60 s in the treatment line as described above were administered with three 27-g needles at a depth of approximately 5.1 mm. The tips of the three-prong needle achieved a cooling temperature of maximum -88 degree Celsius.
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The superficial nature of the field block allowed for the use of the cryoablation needles used in this case as described in Figure 2 to cover the length and depth of the intercostobrachial nerve. The tip of the three-prong needle (Figure 2) achieved a cooling temperature of maximum -88 degree Celsius.