Nerve Injury

Peri-op nerve injury: History: • Symptoms: pain, paresthesia, motor weakness, where, when did it start • Presence of risk factors or conditions that may have neuropathy as a symptoms: DM, Obesity, R Arthritis, PVD, smoking, alcohol, • Drugs that may cause neuropathies → chemo, anti-virals • Review anesthetic records, OR note for documentation of padding, position • A block done or not if yes→ any symptom at the time of the block pain or paresthesias with injection • If the surgical procedure done in the same side → ? surgical complication or prolonged use of a tourniquet, also BP cuff may cause injury Exam: • V/S, complete neurological exam, and mainly examining the affected side sensory, motor, reflex, and looking for any pressure demarcation • Also assess for nerve or dermatomal distribution Obtain a Neurology consult for further evaluation and need for nerve conduction study, and possible MRI • Sensory only F/U in 2wks, motor → further evaluation