Ulnar Neuropathy

Ulnar
Neuropathy After Coronary Artery Bypass Surgery

     

• Swenson
  JD, Bull DA,
  
  
  Postoperative Ulnar Neuropathy Associated with
  Prolonged Ischemia in the Upper Extremity During
  Coronary Artery Bypass Surgery
  
  Anesth
  Analg 85: 1275-1277, 1997
  
   
  
  AS
  many as 37% of cardiac surgery patients experience an
  injury to the ulnar nerve.
  A case of ulnar neuropathy, after a period [3.5
  hours approximately] of decreased arterial blood
  pressure in the right arm is reported.
  
   
  
  Man, 63 years of age, having coronary artery bypass
  surgery, experienced severe right radial artery
  waveform dampening about 10 minutes into surgery. The left radial artery waveform was normal.
  The right radial artery catheter was suspected
  to have a fold at the hub of the catheter. Cardiopulmonary bypass was completed uneventfully, using the left
  radial artery catheter to monitor blood pressure; the
  right radial artery blood pressure remained low.
  On the first postoperative day, the patient
  complained of sensory loss in the right hand, with
  wrist flexion, finger adduction, and abduction
  weakness. After
  3 months, the patient’s strength and sensory
  function returned to near normal; but he reported
  waking up frequently with numbness and weakness. His
  symptoms were reproduced in the left arm when brachial
  artery blood flow was occluded.
  Failure to ensure adequate arterial perfusion
  to the arms, increases the sensitivity of the ulnar
  nerve to ischemia.