Compartment syndrome following prolonged positioning in the lithotomy position

Macintyre, P. A.

doi:10.1111/j.1365-2044.1996.tb07824.x

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…WLCS is very rarely reported to develop in operations that last less than 4 h, which is also the case in our series. No general safe time limit can, however, be identified [10, 15]. We suggest that regular physical examination of the leg, e.g., once every hour, during the first 24 h is included in the observational protocol after abdominal operations with the legs in lithotomy position, in order to reduce the diagnostic delay of compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the abstracts, 54 relevant papers with 78 cases were identified. From the references in these, we identified additional 15 papers, increasing the literature series to 125 cases ( [2,3,[6][7][8][9][10][11], a full list of papers available from the authors). We extracted the same information as above (except the compensation) from the cases in literature.…”

Section: Methodsmentioning

confidence: 99%

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Well Leg Compartment Syndrome After Abdominal Surgery

et al. 2016

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The first 24 h following abdominal surgery of >4 h' duration with elevated legs observation for WLCS should be standard. Pain in the calf is indicative of WLCS, and elevated serum CK can support the diagnosis. Mannitol infusion and acute four-compartment fasciotomy of the lower leg is the treatment. The risk of severe outcome of WLCS increases with duration of the primary operation. A broad support and change of legs' position during surgery are suggested preventative initiatives.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Well Leg Compartment Syndrome After Abdominal Surgery

et al. 2016

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“…Over 30 cases of compartment syndrome have been reported in patients (adults and children) undergoing anesthesia in the lithotomy position and Lloyd Davies position (36)(37)(38)(39)(40)(41)(42)(43). All but three patients, who underwent intramedullary femoral nailing (57,58), had surgery in the abdominal, perineal or pelvic area.…”

Section: Discussionmentioning

confidence: 99%

Does epidural analgesia delay the diagnosis of lower limb compartment syndrome in children?

Johnson

Chalkiadis

2009

Pediatric Anesthesia

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One of the cardinal symptoms of compartment syndrome is pain. A literature review was undertaken in order to assess the association of epidural analgesia and compartment syndrome in children, whether epidural analgesia delays the diagnosis, and to identify patients who might be at risk. Evidence was sought to offer recommendations in the use of epidural analgesia in patients at risk of developing compartment syndrome of the lower limb. Increasing analgesic use, increasing/breakthrough pain and pain remote to the surgical site were identified as important early warning signs of impending compartment syndrome in the lower limb of a child with a working epidural. The presence of any should trigger immediate examination of the painful site, and active management of the situation (we have proposed one clinical pathway). Avoidance of dense sensory or motor block and unnecessary sensory blockade of areas remote to the surgical site allows full assessment of the child and may prevent any delay in diagnosis of compartment syndrome. Focusing on excluding the diagnosis of compartment syndrome rather than failure of analgesic modality is vital. In the pediatric cases reviewed there was no clear evidence that the presence of an epidural had delayed the diagnosis.

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