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Muscle oxygen saturation during surgery in the lithotomy position
L B Svendsen1, P Flink, M Wøjdemann
1Department of Anaesthesia, Rigshospitalet, University of Copenhagen, Denmark.
Clinical Physiology (Oxford, England)
|November 5, 1997
Summary
Surgery in the lithotomy position significantly reduces lower leg oxygen saturation. Calf muscle oxygen levels dropped during urinary tract procedures, indicating potential ischemic risks for patients.
Area of Science:
- Medical Devices
- Surgical Procedures
- Physiology
Background:
- The lithotomy position, commonly used in urinary tract surgery, can compromise lower leg blood flow.
- Ischemic lesions in the lower leg are a known risk associated with prolonged surgical positioning.
Purpose of the Study:
- To assess lower leg oxygen saturation using near-infrared spectroscopy (NIRS) in patients undergoing surgery in the lithotomy position.
- To evaluate the impact of the lithotomy position on lower leg perfusion pressure and muscle oxygenation.
Main Methods:
- Near-infrared spectroscopy (NIRS) was used to measure oxygen saturation in the medial gastrocnemius muscle of 42 patients.
- Lower leg perfusion pressure was calculated by considering mean arterial pressure, pneumatic support pressure, and hydrostatic differences.
- Measurements were taken during the elevation of the lower leg, a common maneuver in the lithotomy position.
Main Results:
- Lower leg oxygen saturation decreased significantly from 68% to 58% (P < 0.01) during the surgical procedure.
- Mean arterial pressure dropped from 100 mmHg to 77 mmHg.
- Lower leg perfusion pressure showed a substantial reduction from 103 mmHg to 21 mmHg.
Conclusions:
- Surgery in the lithotomy position leads to significant desaturation of calf muscles.
- These findings highlight the risk of lower leg ischemia during urinary tract surgery in this position.
- NIRS is a valuable tool for monitoring muscle oxygenation and assessing perfusion during surgical procedures.