EJMS

Abstract

Objective: The brachial plexus is one of the most susceptible structures to injury during anesthesia and surgery. The purpose of this study was to determine the frequency of brachial plexopathies after surgical procedures under general anesthesia and its possible contributing factors. Subjects and Methods: The study included 75 patients undergoing surgical procedures under general anesthesia, not related to shoulder or cervical spine. The surgeon, anesthesiologist and patient were interviewed by three questionnaires. Patients were subjected to neurological examination of the upper limb pre- and postoperatively within 24 to 48 hours. Examination included quick motor examination, sensory examination and evaluation of deep tendon reflexes. Results: Postoperatively, 31 patients (41.3%) had manifestations of brachial plexopathies in the form of neurapraxia. On univariate analysis, age > 50 years, duration of surgery ≥ 5 hours, presence of comorbidities, male gender and smoking were significantly associated with development of brachial plexopathy. On multivariate analysis, only male gender (OR: 3.0; 95%CI: 1.1-8.2) and surgery duration ≥ 5 hours (OR: 3.9; 95%CI: 1.3-12.0) were the independent factors significantly associated with development of brachial plexopathy. Conclusion: Brachial plexopathies are a rather common occurrence after general anesthesia, fortunately of mild form. Duration of surgery and male gender were the independent factors associated with brachial plexopathy.