Abstract
Three patients developed solitary unilateral peripheral femoral neuropathy after vaginal hysterectomy. All were operated under subarachnoid analgesia in the lithotomy position. Straight rod leg supports with swing stirrups were used and the procedures lasted for two and one-half hours. The complication is thought due to the extreme abduction of thighs with external rotation at the hip causing ischaemia of the femoral nerve as it is kinked beneath the tough inguinal ligament. The prognosis was found to be excellent with complete recovery within eight to ten weeks. The complication is preventable by using lateral thigh supports limiting the degree of abduction.
Résumé
On rapporte le cas de trois patientes qui, suite à l’hystérectomie vaginale développèrent une neuropathic fémorale unilatérale et solitaire. Elles subirent l’intervention chirurgicale par l’induction analgésique sousarachnoïdien en position gynécologique. Les complications causées par les suites de cette position doivent être dues à l’abduction extrême du fémur avec rotation externale de la hanche causant une ischémie du nerf fémoral, le nouant sous le ligament inguinal très résistant. Le pronostic s’avéra excellent avec guérison complète suivant les huit à dix semaines. On évite les complications en utilisant des supports latéraux pour la cuisse afin de limiter le degré d’abduction.
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References
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Tondare, A.S., Nadkarni, A.V., Sathe, C.H. et al. Femoral neuropathy: A complication of lithotomy position under spinal anaesthesia report of three cases. Can Anaesth Soc J 30, 84–86 (1983). https://doi.org/10.1007/BF03007722
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DOI: https://doi.org/10.1007/BF03007722