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Published on: December 11, 2013
Lower extremity neuropathies associated with lithotomy positions
M A Warner1, D O Warner, C M Harper
1Perioperative Outcomes Group (Departments of Anesthesiology and Health Science Research), Mayo Foundation, Rochester, Minnesota, USA. warner.mark@mayo.edu
Anesthesiology
|October 6, 2000
Summary
Perioperative lower extremity neuropathies are infrequent, affecting 1.5% of patients. Prolonged lithotomy positioning, especially over 2 hours, significantly increases the risk of developing these temporary nerve issues.
Area of Science:
- Neurology
- Anesthesiology
- Surgical Complications
Background:
- Perioperative lower extremity neuropathies are a potential complication of surgical procedures.
- Understanding their frequency and natural history is crucial for patient safety.
Purpose of the Study:
- To investigate the incidence and clinical course of lower extremity neuropathies in patients undergoing surgery.
- To identify risk factors associated with the development of these neuropathies.
Main Methods:
- Prospective evaluation of 991 adult patients under general anesthesia in the lithotomy position.
- Neurologic assessments and questionnaires administered preoperatively and postoperatively.
- Follow-up for 6 months for patients who developed neuropathies.
Main Results:
- 1.5% of patients developed lower extremity neuropathies, affecting nerves like the obturator, lateral femoral cutaneous, sciatic, and peroneal.
- Symptoms included paresthesia (93%) and pain (27%), with no reported weakness.
- Prolonged duration in the lithotomy position (>2 hours) was a significant risk factor (P=0.006).
Conclusions:
- Lower extremity neuropathies are uncommon post-surgery complications, appearing soon after anesthesia.
- These neuropathies typically resolve within 6 months without long-term disability.
- Reducing lithotomy positioning time may decrease the incidence of these nerve complications.
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