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In a retrospective study of over 1 million patients, ulnar neuropathy (persisting for more than 3 months) occurred in approximately 1 in 2700 patients.¹ Of interest, initial symptoms were most frequently noted more than 24 hr after a surgical procedure. Risk factors included male gender, hospital stay greater than 14 days, and very thin or obese body habitus. More than 50% of these patients regained full sensory and motor function within 1 yr.

Anesthetic technique was not implicated as a risk factor; 25% of patients with ulnar neuropathy underwent monitored care or lower extremity regional technique.

The ASA Closed Claims Project findings support most of these results, including the delayed onset of symptoms and the lack of relationship between anesthesia technique and injury. This study also noted that many neuropathies occurred despite notation of extra padding over the elbow area, further negating compression as a possible mechanism of injury. Finally, the ASA Closed Claims Project investigators found no deviation from the standard of care in the majority of patients who manifested nerve damage perioperatively.

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