title: Neurapraxic complications in operations performed in the lithotomy position.
abstract: In this study, we assessed the incidence and risk factors associated with lower extremity neurapraxia in operations performed in the lithotomy position. A total of 1170 patients, who were operated on in the lithotomy position, were evaluated retrospectively. During the post-operative neurological evaluation, those patients who developed neuropraxic complications were reviewed in detail to identify those with lower extremity sensory and motor deficiencies. The electromyographic (EMG) results of the patients with neurological deficiencies were evaluated. The patients were studied with respect to age, length of operation, type of operation and mode of anaesthesia. Fischer's Exact Probability Test was used for the statistical analyses. Post-operative neurapraxia complications developed in 12 of the patients (1.02%). Of these cases, two had irreversible neurological deficiencies. All other patients recovered without any treatment during the first post-operative month. No correlation was discovered between the type of anaesthesia used and neurapraxia (P> 0.05). However, it was found that age, type of operation and operation time contributed to neurapraxia developing (P < 0.05). Old age (older than 70), prolonged operation time (more than 180 min) and an inappropriate lithotomy position were seen as the main risk factors in developing post-operative neurapraxia. Mistakes in the positioning of the operating staff might be an additional contributing factor.
authors.affiliation: Barbaros mah, Sirma Perde sok, Altunizade Hilal Konutlari, Uskudar, Istanbul, Turkey. eyupg@superonline.com
authors.forename: Eyup
authors.initials: E
authors.lastname: Gumus
authors.forename: Muammer
authors.initials: M
authors.lastname: Kendirci
authors.forename: Kaya
authors.initials: K
authors.lastname: Horasanli
authors.forename: Orhan
authors.initials: O
authors.lastname: Tanriverdi
authors.forename: Gökay
authors.initials: G
authors.lastname: Gidemez
authors.forename: Cengiz
authors.initials: C
authors.lastname: Miroglu
mesh_terms: D000375:Aging / Q000502:physiology; D002769:Cholelithiasis / Q000601:surgery; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D009431:Neural Conduction; D011187:Posture; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*