Leprosy
Mailing List – January 28th, 2010
Ref.: Nerve
function loss after reconstructive surgery
From:
Dinkar
D. Palande, Kurichikuppam,
Pondicherry
,
India
Dear
Angelica Piefer,
Thanks
for sharing this alarming and very unusual complication (LML Jan. 23rd,
2010).
I
feel very sorry hearing about these patients. All
concerned, I feel, should look into the following:
1.
Axillary Block. The
procedure can cause nerve injury as any invasive procedure can
especially if there is faulty technique, too large a needle and
too much anaesthetic agent used.
2.
Tourniquet time appears
to me too long. I
recommend removal of a tourniquet on the arm after 45 minutes.
It can be reapplied if necessary after 15 minutes.
Correct placement of the tourniquet and how much pressure
is applied is important.
3.
One has to check the position of the arm, how, for how long and
on what it is resting during the procedure.
4.
Recovery is possible if
it is only neuropraxia.
With best
wishes,
Dinkar
D. Palande
