A case of sciatic neuropathy after caesarean section under spinal anaesthesia

Postacı, Aysun; Karabeyoglu, Isil; Erdoğan, Gülay; Turan, Özhan; Dikmen, Bayazıt

doi:10.1016/j.ijoa.2006.02.004

Cited by 26 publications

(12 citation statements)

References 12 publications

(17 reference statements)

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“…There was strong evidence of a difference in median comfort scores in the three positions (p = 0.001). The median (IQR [range]) in the left lateral position was 8 (7–9 ), in the ramped with wedge position 6 (5–8 ), and the ramped alone position 7 (6–8 ). The left lateral position was more comfortable than the ramped with wedge position (p = 0.002) and the ramped alone position (p = 0.020); however, there was no evidence of a difference in median comfort scores between the ramped with wedge and ramped alone positions (p > 0.999).…”

Section: Resultsmentioning

confidence: 99%

“…The left lateral tilt of the thorax on the head and neck, even in the ramped position, may produce anatomical distortion to compound an already difficult obstetric airway, and may make the angle for correct cricoid pressure more difficult to judge . Surgical access may be more difficult and compression neuropathy related to wedge placement during caesarean section has been described . All these issues are exacerbated in overweight, obese and morbidly obese pregnant women who are placed in the left lateral tilt position, with the added issue of potentially dangerous tilting on a relatively narrow operating table .…”

Section: Introductionmentioning

confidence: 99%

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Echocardiographic determination of resting haemodynamics and optimal positioning in term pregnant women

et al. 2018

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Optimal positioning for anaesthesia in pregnant women involves balancing the need for ideal tracheal intubation conditions (achieved by the head elevated ramped position), with the prevention of reduced cardiac output from aortocaval compression (achieved by left lateral pelvic tilt). No studies have examined the effect on cardiac output of left lateral pelvic tilt in the ramped position. We studied non-labouring, non-anaesthetised healthy term pregnant women who underwent baseline (left lateral decubitus) cardiac assessment using transthoracic echocardiography. We then compared cardiac output, maternal physiological variables, fetal heart rate and comfort scores in three positions: left lateral decubitus; ramped position with wedge; and ramped position alone. Thirty women completed the study. Mean (SD) age, gestation and body mass index were 33.5 (3.93) years, 38.5 (0.94) weeks and 29.0 (4.0) kg.m , respectively. Mean ejection fraction, left ventricular internal diameter and mitral valve E/e' were 55.2 (6.8) %, 4.70 (0.43) cm and 7.50 (1.82), respectively. There were no differences in cardiac output between the positions (p = 0.503). There were no differences in systolic (p = 0.955) or diastolic (p = 0.987) blood pressure, maternal heart rate (p = 0.133), oxygen saturation, respiratory rate (p = 0.964) or fetal heart rate (p = 0.361) between ramped with wedge and ramped alone positions. Left lateral decubitus was most comfortable (p = 0.001), however, there were no differences in comfort levels between ramped with wedge and ramped alone positions. The ramped position without left lateral tilt is safe and acceptable in non-labouring, non-anaesthetised, healthy term pregnant women. Left lateral pelvic tilt may be unnecessary in the head elevated ramped position in term pregnant women.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Echocardiographic determination of resting haemodynamics and optimal positioning in term pregnant women

et al. 2018

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“…We think that it is also important to understand the prolonged procedures with the leg in the extended knee hemilithotomy position can theoretically lead to ischemia, compartment syndrome, deep venous thrombosis, and nerve and muscle compressions, all of which have been reported in association with surgeries performed with the patient in the lithotomy position and its variations (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). For this reason, we recommend that the knee-extended hemilithotomy Fig.…”

Section: Discussionmentioning

confidence: 99%

The Extended Knee Hemilithotomy Position for Gastrocnemius Recession

Dayton

Wienke

2010

The Journal of Foot and Ankle Surgery

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“…Most lower extremity palsies in the literature are a result of patient positioning during surgeries such as hip arthroplasty, bariatric surgery, and cesarean sections (2,3). Examples of spontaneous cases are toilet seat entrapment, various yoga positions, and use of sedatives or drugs of abuse (4 -8).…”

Section: Bilateral Sciatic Nerve Palsymentioning

confidence: 99%