Dataset Information

Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis.

ABSTRACT:

Background

Postoperative ulnar neuropathy (PUN) is an injury manifesting in the sensory or motor distribution of the ulnar nerve after anaesthesia or surgery. The condition frequently features in cases of alleged clinical negligence by anaesthetists. We performed a systematic review and applied narrative synthesis with the aim of summarising current understanding of the condition and deriving implications for practice and research.

Methods

Electronic databases were searched up to October 2022 for primary research, secondary research, or opinion pieces defining PUN and describing its incidence, predisposing factors, mechanism of injury, clinical presentation, diagnosis, management, and prevention.

Results

We included 83 articles in the thematic analysis. PUN occurs after approximately 1 in 14 733 anaesthetics. Men aged 50-75 yr with pre-existing ulnar neuropathy are at highest risk. Preventative measures, based on consensus and expert opinion, are summarised, and an algorithm of suspected PUN management is proposed, based upon the identified literature.

Conclusions

Postoperative ulnar neuropathy is rare and the incidence is probably decreasing over time with general improvements in perioperative care. Recommendations to reduce the risk of postoperative ulnar neuropathy are based on low-quality evidence but include anatomically neutral arm positioning and padding intraoperatively. In selected high-risk patients, further documentation of repositioning, intermittent checks, and neurological examination in the recovery room can be helpful.

SUBMITTER: Hewson DW

PROVIDER: S-EPMC10308442 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis.

Hewson David W DW Kurien Thomas T Hardman Jonathan G JG

British journal of anaesthesia 20230515 1

<h4>Background</h4>Postoperative ulnar neuropathy (PUN) is an injury manifesting in the sensory or motor distribution of the ulnar nerve after anaesthesia or surgery. The condition frequently features in cases of alleged clinical negligence by anaesthetists. We performed a systematic review and applied narrative synthesis with the aim of summarising current understanding of the condition and deriving implications for practice and research.<h4>Methods</h4>Electronic databases were searched up to ...[more]

PMID: 37198029

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Dataset Information

Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis.

Background

Methods

Results

Conclusions

Publications

Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis.

Similar Datasets

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