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Median Nerve Block at Elbow
Aka: Median Nerve Block at Elbow, Regional Anesthesia of the Median Nerve at the Elbow
- See Also
- Median Nerve Block at Wrist
- Radial Nerve Block
- Ulnar Nerve Block
- Regional Anesthesia (Nerve Block)
- Local Skin Anesthesia
- Field Block
- Hematoma Block
- Digital Block
- Point of Care Ultrasound (POCUS)
- Indications
- Anesthesia of Median Nerve distribution distal to elbow
- Precautions
- Avoid Median Nerve direct injection
- Injection is harmful if improperly done
- Anatomy: Relationships (cubital fossa at elbow)
- Biceps Tendon (lateral)
- Brachial artery
- Median Nerve
- Pronator Teres at humeral head (medial)
- Preparation
- Needle: 27 gauge 1.5 inch
- Skin preparation (e.g. Hibiclens or Betadine)
- See Regional Anesthesia
- Anesthetic
- See Regional Anesthesia for Anesthetic options
- Local Anesthetic 2-5 ml (Ultrasound) or 5-10 ml (landmark)
- Technique
- Images


- Elbow position
- Forearm supinated, elbow resting, partially flexed
- Ultrasound-Guidance (preferred)
- High frequency linear probe in short axis
- Use standard Ultrasound-guided Regional Anesthesia technique
- Linear probe is transverse to Forearm, in-line with the cubital fossa
- Injection site
- Inject 1 cm medial to palpable brachial artery
- Needle insertion
- Apply antiseptic to skin (e.g. Hibiclens or Betadine)
- Aim 30 degrees from medial to lateral elbow in line with antecubital crease
- Insert needle 1 cm until no resistance
- Do not inject if Paresthesias (see below)
- Warning: Distal Paresthesias with needle with injection
- Indicates needle is at Median Nerve
- Do not inject here!
- Remove needle and replace further to the ulnar side
- References
- Yurgil (2020) Am Fam Physician 101(11):654-64 [PubMed]