| Areas of interest | Recommendations/statements |
| Preoperative assessment | - Risk factors for perioperative nerve damage should be identified
- Patient's ability to tolerate the planned position should be assessed
|
| Positioning strategies UE, individual nerves |
| Brachial plexus | - Supine: Arm abduction should be limited to ≤90 degrees
- Prone: Abduction >90 degrees may be tolerated
|
| Ulnar nerve | - Arms abducted: Avoid pressure on ulnar groove, forearm supinated or neutral
- Arms tucked: Forearm should be in neutral position
- When possible avoid elbow flexion, unknown acceptable degree of flexion
|
| Radial nerve | - Avoid pressure on the nerve in spiral groove of humerus
|
| Median nerve | - Avoid extension of elbow beyond preoperative comfortable range
|
| Positioning strategies LE, individual nerves |
| Sciatic | - Avoid stretch of hamstring muscle group beyond preoperative comfortable range
- Consider extension and flexion of both hip and knee joints, as nerve crosses both joints
|
| Femoral | - When possible avoid extension or flexion of the hip
|
| Peroneal | - Avoid pressure on nerve at fibular head
|
| Protective padding | - Arm boards should be padded
- Use chest roll in lateral decubitus position
- Pad at elbow
- Pad fibular head
- Avoid tight padding
|
| Equipment | - When possible avoid use of shoulder braces in steep head down position
- When possible avoid blood pressure cuff below the antecubital fossa
|
| Postoperative assessment | - May lead to early recognition of neuropathy
|
| Documentation of positioning | - May focus attention on positioning
- May provide information that leads to improved patient care
|
