Attention to detail in positioning and knowing the risk factors like diabetes, thyroid disease, alcohol, “Established peripheral neuropathy, pre-existing (but subclinical) peripheral neuropathy, profound hypothermia, hypovolaemia, hypotension, hypoxaemia, electrolyte disorders, malnutrition, small or large body mass index (BMI), tobacco use and anatomical variants (such as the presence of cervical ribs) may increase the susceptibility of peripheral nerves to peri-operative injury”.
The complexity of predisposing conditions, surgical injury and tourniquet use are explored in the ASRA practice advisory ASRA advisory
Anesthesiology (Here) publishes guidelines Jan 2018 for the prevention of peripheral nerve injury. Avoid pressure on nerves with padding if needed, avoid excessive flexion or extension of any joint, and none of those pesky shoulder brace thingies. And I’ve saved you a lot of reading!