MAY 2025

The anaesthesia subcommittee reviewed a case of significant common peroneal nerve injury following prolonged use of non-invasive blood pressure (NIBP) monitoring in the lower limb. The potential for injury was possibly increased by use of NIBP over thromboembolic deterrent (TED) stockings.

It is recommended that:

  1. When the upper limb cannot be used for non-invasive pressure monitoring, and a prolonged case is anticipated, there should be a low threshold for insertion of an arterial line to monitor blood pressure. 
  2. Rotation of a lower limb NIBP cuff could also be considered in some circumstances, but this is often difficult without disturbing the sterile surgical field.
  3. It should be noted that the use of TED stockings and sequential compression devices in combination are not recommended.
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