title: Association between the use of gel pads under patients' knees and the incidence of peroneal neuropathy following liver transplantation.
abstract: BACKGROUND
  There have been intermittent reports of peroneal neuropathy (PN) occurring after liver transplantation. Although PN may not be viewed as a serious complication by liver transplant (LT) recipients who require the transplant for survival, PN can significantly reduce quality of life. The incidence of PN appears to have increased after the use of gel pads was introduced. These gel pads, which are placed under patients' knees during surgery, are used to reduce lower back strain and prevent contact between the peroneal nerve at the fibular head and the hard surface of the operating table. The aim of the present study was to investigate the association, if any, between the use of gel pads and the incidence of PN.
  
  
  METHODS
  The medical records of 261 adult LT recipients were retrospectively reviewed. The recipients were divided into gel pad (n = 167) and non-gel pad (n = 94) groups. The incidence and possible risk factors of PN were compared between the two groups.
  
  
  RESULTS
  The overall incidence of PN was 8.0% (21/261). The occurrence of PN was significantly higher in the gel pad group than in the non-gel pad group (10.8% vs. 3.2%; p < 0.05). Other possible risk factors were comparable between the two patient groups.
  
  
  CONCLUSIONS
  As the use of gel pads may increase the incidence of PN, we recommend against the use of gel pads under the knees of LT recipients.
authors.forename: Gaab Soo
authors.initials: GS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul 134-791, Korea. medisun74@naver.com.
authors.forename: Jin Sun
authors.initials: JS
authors.lastname: Yoon
authors.forename: Rim
authors.initials: R
authors.lastname: Kee
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Shin
authors.forename: Justin Sangwook
authors.initials: JS
authors.lastname: Ko
authors.forename: Mi Sook
authors.initials: MS
authors.lastname: Gwak
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Hwang
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D005782:Gels; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000150:complications* / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D017116:Low Back Pain / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D020427:Peroneal Neuropathies / Q000209:etiology* / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D011482:Protective Devices; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005782:Gels