Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 11

Nerve injuries associated with surgical operations are well recognized and described in literature. Ulnar neuropathy, brachial plexus, and lumbosacral roots injuries are the most frequent as shown by two large reviews on anesthesia-related nerve damage from the American Society of Anesthesiologists closed claims study (Kroll DA 1990, Cheney FW 1999). Several factors such as section, compression, traction, and ischemia, contribute to the nerve injuries but the exact mechanism(s) in an individual case often is unclear. We describe a case of perioperative bilateral median neuropathy at the distal forearm, an uncommon site of nerve injury, which we ascribe to demyelinative conduction block secondary to nerve compression. Nerve conduction studies precisely localized the area of abnormality. There is a limited understanding of the relationships between conventional perioperative care and the genesis of peripheral nerve lesions. As a result, there is a lack of agreement in literature on the correct standards for positioning the patient during anesthesia. In selected cases nerve conduction studies at the onset of symptoms may provide insights into localization, mechanism and prognosis of nerve lesions. We believe that a timely and proper electrophysiological study may be helpful for understanding the perioperative nerve injuries as well as for determining the best preventive strategies.