Nerve function loss after reconstructive surgery

Leprosy Mailing List – January 28^th, 2010

Ref.: Nerve function loss after reconstructive surgery

From: Dinkar D. Palande, Kurichikuppam, Pondicherry , India

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Dear Angelica Piefer,

Thanks for sharing this alarming and very unusual complication (LML Jan. 23^rd, 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