P049: RADIAL NERVE INJURY PROVOKED BY ROUTINE INTRAVENOUS CANNULATION: A CASE REPORT
Bryan Kerner, DO, Pablo Fumero, MD, Gerald P Rosen, MD; Mount Sinai Medical Center of Florida
Intravenous (IV) cannulation is an intricate aspect of providing anesthesia. Berry et al and Newman et al estimated that 1 of 21,000 to 26,700 patients undergoing IV cannulation suffered neurologic injuries severe enough to seek medical attention. A common site for IV cannulation in surgical patients is the dorsal aspect of the wrist and forearm. In this location, the cephalic vein lies in close proximity to sensory branches of the radial nerve, leaving it susceptible to injury.
Isolated neuropathy of the superficial branch of the radial nerve, or “Cheiralgia paresthetica”, as first described by Wartenberg in 1932 can lead to various painful outcomes, including neuroma formation and complex regional pain syndrome, type 2. Upon damage, surgical repair is often required. Unfortunately, repair efforts are successful in just 50% of patients, leaving patients with residual sensory loss and dysesthesias. Iatrogenic radial nerve injury does occur. Because this condition is avoidable and may have lifelong impact, it is important to raise awareness among anesthesiologists. This case report describes the clinical characteristics of a 42 year old female with radial nerve injury secondary to IV cannulation of the cephalic vein.