Cubital fossa venipuncture sites based on anatomical variations and relationships of cutaneous veins and nerves.

Venipuncture is a routine procedure performed at medical institutions for blood collection and blood donation, as well as for health screening and testing. Venipuncture is invasive and usually mildly painful, but it occasionally causes internal bleeding and chronic persistent pain, which is referred to as complex regional pain syndrome. The most common site of venipuncture is the upper arm. The present study macroscopically and anatomically ascertained positional relationships between cutaneous nerves and veins in the cubital (aka antecubital) fossa in many cadaveric dissections to determine the risk of peripheral nerve injury during venipuncture. We identified the most suitable venipuncture site in the upper arm. The medial cutaneous nerve of the forearm (MCNF) passed above the median cubital vein (MCBV) in 27 of 128 cases (21.1%), and was located inferior to the MCBV in 37 of 128 cases (28.9%). The MCBV also passed above the lateral cutaneous nerve forearm (LCNF) in 8 of 128 cases (6.2%). The LCNF was located deeper than the MCBV in 56 of 128 cases (43.8%). The distribution of cutaneous veins and nerves widely varies, and while no single area suitable for all individuals was identified, puncture of the MCBV near the cephalic vein is the least likely to cause nerve damage. (c) 2008 Wiley-Liss, Inc.