| Effects of lithotomy position and external compression on lower leg muscle compartment pressure. | |
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MedLine Citation:
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PMID: 11575534 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Case reports have suggested that externally applied pressure from antithrombosis devices may contribute to the development of compartment syndromes during extended surgery in the lithotomy position. The purpose of this study was to assess the effects of a pneumatic compression device on directly measured intracompartment pressure in the lower leg with the leg positioned in the lithotomy position. METHODS: In 25 conscious, healthy men and women, the authors measured pressure within the tibialis anterior muscle compartment with the leg supine and in the lithotomy position with and without intermittent compression. Three different devices were used to keep the leg in the lithotomy position, supporting the leg either behind the knee, under the calf, or at the ankle. RESULTS: The lithotomy position with support behind the calf or knee increased intracompartment pressure to 16.5+/-3.4 versus 10.7+/-5.8 mmHg supine (mean +/- SD; P < 0.05). The addition of intermittent compression decreased pressure to 13.4+/-5.1 mmHg during lithotomy (P < 0.05) and to 9.1+/-7.0 mmHg in the supine position (P < 0.05). In contrast, the lithotomy position with support near the ankle decreased intracompartment pressure to 8.7+/-5.6 versus 13.3+/-5.1 mmHg supine (P < 0.05). The addition of intermittent compression decreased pressure to 6.5+/-5.4 mmHg during lithotomy (P < 0.05) and to 10.3+/-4.7 mmHg in the supine position (P < 0.05). CONCLUSIONS: These results show that the lithotomy position is associated with changes in intracompartment pressure that are dependent on the method of leg support used. Furthermore, they indicate that intermittent external compression can reduce intracompartment pressure in the lower leg. Therefore, increases in intracompartment pressure during surgery in the lithotomy position with the calf or knee supported may be one of the factors that contribute to the development of compartment syndrome. Further, use of intermittent external compression may significantly reduce this pressure increase. |
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Authors:
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S D Pfeffer; J R Halliwill; M A Warner |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesiology Volume: 95 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2001 Sep |
Date Detail:
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Created Date: 2001-09-28 Completed Date: 2001-10-11 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 632-6 Citation Subset: AIM; IM |
Affiliation:
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Mayo Graduate School of Medicine, Department of Anesthesiology, Mayo Medical School, Rochester, Minnesota 55905, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Compartment Syndromes / etiology* Female Humans Male Posture* Pressure |
| Comments/Corrections | |
Comment In:
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Anesthesiology. 2002 Jul;97(1):284-5; author reply 285
[PMID:
12131142
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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