Under general anesthesia, which peripheral nerve is most likely to be injured?

Under general anesthesia, which peripheral nerve is most likely to be injured?

• A. Ulnar nerve
• B. Median nerve
• C. Radial nerve
• D. Common peroneal nerve

Answer: (A)

Nerve injuries under anesthesia are usually due to compression or traction since the patient cannot report discomfort. The ulnar nerve at the elbow is especially vulnerable because it runs in a superficial groove behind the medial epicondyle and is easily compressed when the arm is flexed and pressed against a hard surface or poorly padded. Prolonged elbow flexion with inadequate padding during surgery places sustained pressure on this nerve, making neurapraxia or mild axonal injury more likely than with other nerves. While other nerves can be injured in certain positions—radial nerve with improper shoulder/arm positioning or common peroneal nerve with leg pressure—the ulnar nerve injury is the most common in standard anesthesia practice due to the typical forearm/elbow positioning and contact during many procedures. Preventive focus on gentle, well-padded positioning and avoiding prolonged elbow flexion helps reduce this risk.

Nerve injuries under anesthesia are usually due to compression or traction since the patient cannot report discomfort. The ulnar nerve at the elbow is especially vulnerable because it runs in a superficial groove behind the medial epicondyle and is easily compressed when the arm is flexed and pressed against a hard surface or poorly padded. Prolonged elbow flexion with inadequate padding during surgery places sustained pressure on this nerve, making neurapraxia or mild axonal injury more likely than with other nerves. While other nerves can be injured in certain positions—radial nerve with improper shoulder/arm positioning or common peroneal nerve with leg pressure—the ulnar nerve injury is the most common in standard anesthesia practice due to the typical forearm/elbow positioning and contact during many procedures. Preventive focus on gentle, well-padded positioning and avoiding prolonged elbow flexion helps reduce this risk.