ABSTRACT

A 25-year-old woman with hidradenitis suppurativa was admitted with recurrent boils in the right axilla for six months, resistant to conservative management. Excision and primary closure were planned, and regional anesthesia was achieved with a combined upper trunk and intercostobrachial nerve (ICBN) block. After sedation using midazolam and fentanyl, ultrasound-guided injection of the anesthetic comprised 6-7 ml of 0.5% bupivacaine to the upper trunk and another 6 ml to the ICBN. A patchy anaesthesia in the upper lateral region was managed with an extra 2 ml of local infiltration of 2% lignocaine. The surgery was carried out pain-free for half an hour. The clinical significance of blocking ICBN in anaesthesia for axillary surgery is highlighted. Axillary area is supplied by multiple nerves with a lot of individual variations. This case highlights the success of focal regional anaesthesia in superficial axillary operations, focusing on the advantage of ultrasound guidance for accurate nerve localisation and effective pain relief, avoiding systemic side effects. Keywords: Axilla, Hidradenitis, anaesthesia, block, intercostobrachial nerve
Publication date: 01/08/2026

https://www.ijbpas.com/pdf/2026/August/MS_IJBPAS_2026_10257.pdf

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https://doi.org/10.31032/IJBPAS/2026/15.8.10257