Positioning Injuries in Anesthesia: An Update

SIGNIFICANCE AND INCIDENCE Anesthesia professionals, operating room (OR) nurses, and surgeons worry about injury to skin and other organs when positioning the anesthetized patient. The true incidence of all perioperative position-related injury is subject to conjecture. An important type of position-related injury is peripheral nerve injury. The incidence varies with surgical procedure and positioning. For example, ulnar neuropathy has been found in as many as 26% of patients undergoing open-heart surgery [1], whereas lower extremity neuropathy occurred in 1.5% of patients in the lithotomy position [2]. The incidence of ulnar neuropathy is estimated at 0.46% after noncardiac surgery [3]. According to data from the American Society of Anesthesiologists (ASA) Closed Claims Database, peripheral nerve injuries represent the second largest class of adverse outcomes and account for 16% of all claims [4].