RT Book, Section
A1 Bailin, Michael
A1 Spanakis, Spiro
SR Print(0)
ID 5010041
T1 Practice Advisory for the Prevention of Perioperative Peripheral Neuropathies
T2 Guidelines
YR 2000
FD 2000
PB The McGraw-Hill Companies, Inc.
PP New York, NY
SN 9781264269518
LK accessanesthesiology.mhmedical.com/content.aspx?aid=5010041
RD 2024/04/19
AB |PrintPractice  Advisory  for  the  Prevention  of  Perioperative  Peripheral  NeuropathiesComments  by  Spiro  Spanakis,  DOPreoperativelyIntraoperativelyPostoperativelyGeneralFormal  history  to  identify  those  at  riskPreexisting  conditions  that  may  increase  riskBody  habitusNeurologic  symptomsDiabetes  mellitusPeripheral  vascular  diseaseAlcohol  dependencyArthritisMale  genderDocumentation  of  specific  positioning  measures  may  be  helpful  in  improvement  processesAssessment  of  postoperative  nerve  function  may  identify  peripheral  neuropathyUpper  ExtremityIdentify  position  of  comfortPlan  to  perform  periodic  assessment  of  upper  extremity  position  during  proceduresArm  abduction  (supine)—limit  to  less  than  90°Arm  abduction  (prone)—limit  but  greater  than  90°  permissibleDecrease  pressure  on  postcondylar  (ulnar  n.)  groove  of  the  humerusIf  arms  tucked  in  supine  position,  leave  in  neutral  positionMonitor  flexion  of  elbow  (extension  may  stretch  median  n.)Monitor  pressure  on  spiral  groove  (radial  n.)  of  the  humerusLower  ExtremityIdentify  position  of  comfort  as  stretching  the  biceps  femoris  muscle  beyond  the  normal  range  of  motion  may  increase  the  risk  of  sciatic  neuropathyMonitor  stretching  of  hamstring  muscle  group  (protect  sciatic  n.)Monitor  flexion  of  both  hip  and  knee  jointsNeither  hip  flexion  nor  extension  changes  risk  for  femoral  n.  injuryPrevent  prolonged  pressure  on  the  peroneal  n.  at  the  fibular  headProtective  PaddingSpecific  padding  equipment  (e.g.,  foam,  gel  pads,  specialized  armboards)  should  be  availablePadded  upper  extremity  arm  boards  may  be  beneficial,  especially  at  the  elbow  jointChest  rolls  in  the  lateral  position  may  decrease  the  risk  of  brachial  plexus  neuropathyPadding  that  prevents  pressure  on  the  peroneal  nerve  at  the  fibular  head  may  decrease  the  risk  of  peroneal  neuropathyInappropriately  applied  padding  may  induce  peripheral  nerve  injuryEquipmentThe  use  of  properly  functioning  automated  blood  pressure  cuffs  has  not  been  shown  to  increase  the  risk  of  neuropathyAutomated  blood  pressure  cuffPlacement  proximal  to  the  antecubital  fossa  may  not  reduce  risk  of  peripheral  neuropathyShoulder  bracesIn  Trendelenburg  position,  brachial  plexus  neuropathy  may  result