Acute Radial Nerve Paralysis Related to Use of Automatically Cycled Blood Pressure Cuff During Thoracic Surgery

DEMİR A., Demir S. E., GÜNLÜOĞLU M. Z., Melek H., Ulukoz Z. N., Dincer S. I.

HASEKI TIP BULTENI-MEDICAL BULLETIN OF HASEKI, cilt.48, sa.3, ss.110-112, 2010 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 48 Sayı: 3
  • Basım Tarihi: 2010
  • Dergi Adı: HASEKI TIP BULTENI-MEDICAL BULLETIN OF HASEKI
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.110-112
  • İstanbul Üniversitesi Adresli: Hayır

Özet

Peripheral nerve paralysis is one of the rare complications following surgical procedures under general anesthesia. We report four cases with acute radial nerve palsy presenting as wrist drop due to compression injury from automatic cycled blood pressure (BP) monitoring during thoracic surgical procedures. The patients were laid supine on the operating table with both of their arms 80-85 degrees abducted, and fixed on arm boards. All patients were cuffed to measure their BP with a large adult cuff. Blood pressure was measured at 5-minute time intervals during the surgery. On postoperative period, patients complained of wrist and finger drop on the side of BP monitoring during surgery. The nerve conduction velocity and electromyography tests revealed a conduction block in the radial nerve above the elbow level. The paralysis in all patients was observed on the side where the cuff was affixed. Rehabilitation was recommended and started immediately. Static splinting, range of motion exercises, strengthening exercises and biofeedback exercises were used. Paralyses resolved within three months in all the patients. Radial nerve paralysis can be seen as a rare complication most likely due to cuff pressure of automatic BP monitor during thoracic procedures. The incidence of peri-operative nerve injuries can be reduced being aware of the problems. Physical therapy is effective in treating this complication.