Be sure to appropriately position and cushion intensive care unit and anesthetized patients because they are prone to the development of focal neuropathies at compression sites (e.g., ulnar nerve at elbow, peroneal nerve at fibular head, and radial nerve in spiral groove), due to positioning and weight loss.

Be aware of pressure points when the patient is under anesthesia or medically unable to sense or respond to pressure points or extremities in limb position. Pre-existing conditions to note during a preoperative history and physical include body habitus, diabetes mellitus, pre-existing neurologic conditions, peripheral vascular disease, alcohol dependence, and arthritis.

Especially in patients with a limited range of motion, assess if the patient can tolerate the anticipated operative position before administering anesthesia. The most common sites of injury under anesthesia as analyzed by closed claim analysis are the ulnar nerve, followed by the brachial plexus. Arm abduction should not exceed 90 degrees in supine patients but may do so in prone patients. Arms should be positioned to decrease pressure on the postcondylar groove of the humerus so as to protect the ulnar nerve. For instance, when the patient is supine with the arms abducted, the forearm should be supinated or in a neutral position.