A 52 year old female patient was operated under the diagnosis of stomach cancer, She was very obese: her body weight and height were 95.5 kg and 161.5 cm, respectively. Radical subtotal gastrectomy was performed and the operation time was 4 hour
and 40
minutes. The day following surgery, signs of right radial nerve palsy including wrist drop were noted. Neurologic examination revealed 0-1/5 power of the dorsum of the hand. The electromyography & nerve conduction test revealed incomplete right
radial
nerve injury above elbow level. During surgery, the patient was in the supine position, the right arm fully adducted to the lateral side of the trunk, and the left arm was 90 degree abducted from the trunk. The blood pressure cuff had been
applied
to
the right upper arm and automated sequential blood pressure measurement's performed every 5 minutes during the operation. Thirty minutes into the procedure, a Kent retractor had been applied, the side frame of which contacted the patient's right
upper
arm. We hypothesize that firm pressure from the retractor frame against radial nerve where it passes superficially in the upper arm was responsible for the injury. No abnormalities in function of the automatic cuff were discovered. The patient
was
discharged 19 days after operation with partial recovery of the radial nerve palsy. Two months later the radial nerve palsy had completely resolved. (Korean J Anesthesiol 1995; 29: 156~159)
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