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KMID : 0356919930260061306
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Korean Journal of Anesthesiology
1993 Volume.26 No. 6 p.1306 ~ p.1308
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A Case Report of Brachial Plexus Palsy after Laparascopy Assisted Vaginal Hysterectomy
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김성배
임혜자/공명훈/채병국/장성호
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Abstract
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Trendelenburg position has been used for the low abdominal and pelvic surgery or for the management of the hypotensive patients. But, various adverse effects can also occur in steep Trendelenburg position, of which brachial plexus injury has been
known
as the most common nerve injury during this position under the general anesthesia especially when the shoulder braces are used.
We experienced a case of brachial plexus palsy in a 53 year old woman who had a laparascopy assisted vaginal hysterectomy(LAVH) under the general anesthesia for myoma uteri for four and a half hours. During the operation she was in a 30°-tilting
Trendelenburg and combine lithotomy position with her arms tucked at her side with drawsheet and shoulder braces were placed over the acromioclavicular joints bilaterally. In the morning of the postoperative 1st day, she complained the right
shouder
pain and the right arm tingling sensation and weakness. After needle electromyography and nerve conduction study, it was decided that she got an intraoperative brachial plexus injury mainly involving the lateral cord of the brachial plexus,
resulting
from the nerve compression caused by shoulder braces in Trendelenburg position. The symptoms were improved after the physical therapy and she was recommended to take more physical therapy after discharge.
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