Postoperative peripheral neuropathies in general surgery

Introduction: Postoperative nerve lesions beyond the operative area, the so called positioning traumas are considered uncommon in general surgery. But they can have serious consequences for the patient and the surgeon, includ ing forensic sequelae. The objective of this work was to describe the incid ence, pattern, risk factors and course of postoperative neuropathies in gen eral surgery and to identify indicators to prevent these complications. Methods: Based on neurologic records we reviewed all postoperative peripher al neuropathies that occurred in the Department of General Surgery of the U niversity Hospital Freiburg in the time period from January 1979 to Decembe r 1990. Lesions that occurred as a direct operative effect were excluded. Results: In 35 patients 50 nerve lesions were observed, representing an inc idence of 0.12% of all operations during this time period. Most frequently lesions of the n. peroneus occurred, followed by the n. ulnaris, n. cutaneo us femoris lateralis and n. medianus. Nerve lesions were observed in every body position and as early as after 15 min. Postoperative nerve lesions hav e a favorable prognosis. Discussion: Nerve lesions caused by positioning can occur during any operat ion with any duration in general surgery. They should be avoided by thoroug h and careful positioning. Also the patient must be informed about the poss ibility of nerve lesions caused by the positioning.