Technology in the Operating Room and Brachial Plexus Neuropraxia
Keywords:
Periopheral nerves, injuries, anesthesia, Brachial Plexus Neuropathies
Abstract
This case refers to a 17-year old patient who underwent osteosynthesis of the femur due to middle third fracture following a traffic accident. During the post-op, the patient showed weakness and hypoesthesia of the upper left limb that lead to a diagnosis of brachial plexus neuropraxia. The underlying triggering factor identified was inadequate positioning of the image intensifier during the course of surgery, with extreme abduction of the limb. The evolution and management of the case is shown, together with a review about this perioperative complication.
References
1. Sawyer RJ, Richmond MN, Hickey JD, Jarrratt JA. Peripheral nerve injuries associated with anaesthesia. Anaesthesia. 2000;55(10):980-91.
2. Bhananker SM, Domino KB. What actions can be used to prevent peripheral nerve injury? In: Fleisher LA. Evidence-based practice of anesthesiology. 2nd Ed. Philadelphia: Saunders Elsevier; 2009. p. 210-8.
3. Morell RC, Prielipp RC, Harwood TN, James RL, Butterworth JF. Men are more susceptible than women to direct pressure on unmyelinated ulnar nerve fibers. Anesth Analg 2003;97(4):1183-8.
4. Kroll DA, Caplan RA, Posner K, Ward RJ, Cheney FW. Nerve injury associated with anesthesia. Anesthesiology. 1990;73(2):202-7.
5. Welch MB, Brummet ChM, Welch TD, Tremper KK, Shanks AM, Guglani P, et al. Perioperative peripheral nerve injuries: a retrospective study of 380,680 cases during a 10-years period at a single institution. Anesthesiology. 2009;111(3):490-7.
6. Seddon HJ. Three types of nerve injury. Brain. 1943;66(4):237-88.
7. Stoelting RK. Postoperative ulnar nerve palsy-- is it a preventable complication? Anesth Analg. 1993;76(1):7-9.
8. Warner MA, Warner DO, Harper CM, Schroeder DR, Maxson PM. Lower extremity neuropathies associated with lithotomy positions. Anesthesiology. 2000;93(4):938-42.
9. Chambers WA. Peripheral nerve damage and regional anaesthesia. Br J Anaesth. 1992;69:429-30.
10. Selander D, Brattsand R, Lundborg G, Nordborg C, OlssonY. Local anesthetics: importance of mode of application, concentration and adrenaline for the appearance of nerve lesions. An experimental study of axonal degeneration and barrier damage after intrafascicular injection or topical application of bupivacaine (Marcain). Acta Anaesthesiol Scand. 1979;23(2):127-36.
11. Goodyear-Smith F, Halliwell J. Anticonvulsants for neuropathic pain gaps in the evidence. Clin J Pain. 2009;25(6):528-36.
2. Bhananker SM, Domino KB. What actions can be used to prevent peripheral nerve injury? In: Fleisher LA. Evidence-based practice of anesthesiology. 2nd Ed. Philadelphia: Saunders Elsevier; 2009. p. 210-8.
3. Morell RC, Prielipp RC, Harwood TN, James RL, Butterworth JF. Men are more susceptible than women to direct pressure on unmyelinated ulnar nerve fibers. Anesth Analg 2003;97(4):1183-8.
4. Kroll DA, Caplan RA, Posner K, Ward RJ, Cheney FW. Nerve injury associated with anesthesia. Anesthesiology. 1990;73(2):202-7.
5. Welch MB, Brummet ChM, Welch TD, Tremper KK, Shanks AM, Guglani P, et al. Perioperative peripheral nerve injuries: a retrospective study of 380,680 cases during a 10-years period at a single institution. Anesthesiology. 2009;111(3):490-7.
6. Seddon HJ. Three types of nerve injury. Brain. 1943;66(4):237-88.
7. Stoelting RK. Postoperative ulnar nerve palsy-- is it a preventable complication? Anesth Analg. 1993;76(1):7-9.
8. Warner MA, Warner DO, Harper CM, Schroeder DR, Maxson PM. Lower extremity neuropathies associated with lithotomy positions. Anesthesiology. 2000;93(4):938-42.
9. Chambers WA. Peripheral nerve damage and regional anaesthesia. Br J Anaesth. 1992;69:429-30.
10. Selander D, Brattsand R, Lundborg G, Nordborg C, OlssonY. Local anesthetics: importance of mode of application, concentration and adrenaline for the appearance of nerve lesions. An experimental study of axonal degeneration and barrier damage after intrafascicular injection or topical application of bupivacaine (Marcain). Acta Anaesthesiol Scand. 1979;23(2):127-36.
11. Goodyear-Smith F, Halliwell J. Anticonvulsants for neuropathic pain gaps in the evidence. Clin J Pain. 2009;25(6):528-36.
How to Cite
1.
Jaramillo Gómez HD, Gómez Buitrago LM, Duque Quintero JR. Technology in the Operating Room and Brachial Plexus Neuropraxia. Colomb. J. Anesthesiol. [Internet]. 2010 Apr. 1 [cited 2024 Apr. 28];38(2):260-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/587
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Published
2010-04-01
How to Cite
1.
Jaramillo Gómez HD, Gómez Buitrago LM, Duque Quintero JR. Technology in the Operating Room and Brachial Plexus Neuropraxia. Colomb. J. Anesthesiol. [Internet]. 2010 Apr. 1 [cited 2024 Apr. 28];38(2):260-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/587
Issue
Section
Case Report / Case Series
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