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March 11, 1974

Prevention of Postsurgical Ulnar Neuropathy

Author Affiliations

Suburban Hospital Bethesda, Md

JAMA. 1974;227(10):1123-1124. doi:10.1001/jama.1974.03230230015011

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To the Editor.—  Ulnar paresthesia involving one or both hands or forearms, can be a rare but distressing and troublesome complication of major surgical procedures performed under general anesthesia on parts of the body other than the arms. Operations undertaken when the patient is in the face-down position (eg, lumbar laminectomy) are a particular source of this complication, but we have seen ulnar paresthesia of lengthy persistence following appendectomy, removal of a knee cartilage, repair of dislocation of the shoulder, and cholecystectomy.The causative factor appears to be compression of the ulnar groove of the elbow on the edge of an armboard or on an outrigging bar that runs along the edge of the operating table and is used for attachment of lateral supports such as those employed in operations upon the kidney. The arm is often held in place alongside the body by the lifting sheet used to transport