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Postoperative Median Nerve Injury

You get a call from you orthopedic surgical colleague to say that the patient that you anesthetized for an 11-h spine surgery operation last week has developed a left median nerve conduction block. The diagnosis has been confirmed by a neurologist who is at a loss to find any reason for this. There is no evidence of infection, hematoma, or vascular insufficiency of the hand. The patient has no other problems and is otherwise happy with her surgery. You tell your colleague that you will get back to him. In reviewing your anesthetic record, you see that the anesthetic was uneventful with stable vital signs throughout. Your IV access included two large-bore IVs in the right forearm and the back of right hand. A right subclavian triple-lumen catheter had also been inserted. In addition, she had a left radial intraartery catheter. The arms were both placed forward alongside the head. You go and see the patient and apologize for what has happened. You ask to see her hand. There is nothing abnormal noted with the overlying skin of the left hand and the oxygen saturation reads 100%?

Keywords

Oxygen Saturation Median Nerve Overlie Skin Arterial Puncture Anesthetic Record 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Chowet AL, Lopes JR, Brock-Utne JG, Jaffe RA. Wrist hyperextension leads to median nerve conduction block. Anesthesiology 2004;100:287-291.CrossRefPubMedGoogle Scholar
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    Cheney FW, Domino KB, Caplan RA, Posner KL. Nerve injury associated with anesthesia: A closed claim analysis. Anesthesiology 1999;90:1062-1069.CrossRefPubMedGoogle Scholar
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    Coppieters MW, Van de Velde M, Stappaerts KH. Positioning in anesthesiology: Towards a better understanding of stretch-induced perioperative neuropathies. Anesthesiology 2002;97:75-81.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

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