The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Postoperative pain experienced by the candidates for gynecological surgery with lithotomy position

Document Type : Original Article

Authors
Leila Sadati 1
Zahra Nouri Khanegah 1
Nazanin Sarraf Shahri 2
Fatemeh Edalat 3
1 Instructor, Department of Operating Room, School of Paramedicie, Alborz University of Medical Sciences, Karaj, Iran.
2 Instructor, Department of Operating Room, School of Paramedicie, Iran University of Medical Sciences, Tehran, Iran.
3 M.Sc. Student of Intensive Care Nursing, School of Paramedicie, Alborz University of Medical Sciences, Karaj, Iran.
10.22038/ijogi.2022.19750
Abstract
Introduction: Failure to follow the standard principles in establishing lithotomy position will cause can lead to serious complications such as pain. This study was performed with aim to evaluate the pain experienced by patients in pressure areas in lithotomy position.
Methods: This descriptive-analytical cross-sectional study was performed in 2017 on 200 female patients who had undergone gynecological surgery using lithotomy position in the teaching hospital of Karaj. The researcher-made questionnaire was used to assess pain experienced by patients; the questionnaire includes: patients' demographic information and the checklist of recording the amount and severity of pain using a standard ten-point scale. Data were analyzed using SPSS software (version 22) and descriptive and inferential statistical tests of Chi-square, Mann-Whitney and Kendall correlation coefficient. P< 0.05 was considered statistically significant.
Results: Based on the results of data analysis, within 24 hours after the surgery, 180 patients had complaint from low back pain, 94 from the groin region pain, 164 from the knee pain and 34 from the ankle pain in moderate to severe level. Also, a high correlation was observed between the variables of patients' body mass index and duration of surgery with the incidence of pain in some areas such as the lumbar region and the ankle region.
Conclusion: In this study, a significant percentage of patients following placed in the lithotomy position experienced postoperative pain in different areas.
Keywords
Gynecological surgery
Pain
Position
  1. Ahmoum H, Boughrara M, Su’ait MS, Kerouad M. Effect of position and concentration of Li on ZnO physical properties: Density functional investigation. Chemical Physics Letters 2019; 719:45-53.
  2. Krepsz V. Vowel lengthening—Effect of position, age, and phonological quantity. InThe 9th Workshop on Disfluency in Spontaneous Speech 2019:59.
  3. Aydemir Ö, Aslan FE, Karabacak Ü, Akdaş Ö. The effect of exaggerated lithotomy position on shoulder pain after laparoscopic cholecystectomy. Pain Management Nursing 2018; 19(6):663-70.
  4. Stornelli N, Wydra FB, Mitchell JJ, Stahel PF, Fabbri S. The dangers of lithotomy positioning in the operating room: case report of bilateral lower extremity compartment syndrome after a 90-minutes surgical procedure. Patient safety in surgery 2016; 10(1):1-4.
  5. Yamamoto T, Fujie A, Tanikawa H, Funayama A, Fukuda K. Bilateral well leg compartment syndrome localized in the anterior and lateral compartments following urologic surgery in lithotomy position. Case reports in orthopedics 2018; 2018.
  6. Deveneau NE, Forbis C, Lipetskaia L, Kinman CL, Agrawal A, Herring NR, et al. The effect of lithotomy position on nerve stretch: a cadaveric study. Female pelvic medicine & reconstructive surgery 2017; 23(6):457-61.
  7. Taneja SS, Shah O. Complications of urologic surgery e-book: prevention and management. Elsevier Health Sciences; 2017.
  8. Warner MA, Martin JT, Schroeder DR, Offord KP, Chute CG. Lower-extremity motor neuropathy associated with surgery performed on patients in a lithotomy position. The Journal of the American Society of Anesthesiologists 1994; 81(1):6-12.
  9. Small C, Laycock H. Acute postoperative pain management. Journal of British Surgery 2020; 107(2):e70-80.
  10. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of Postoperative Pain: a clinical practice guideline from the American pain society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' committee on regional anesthesia, executive committee, and administrative council. The journal of pain 2016; 17(2):131-57.
  11. Rowbotham DJ. National Institute of Academic Anaesthesia. Bull Roy Coll Anaesthet 2008; 48:2516-7.
  12. Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology 2013; 118(4):934-44.
  13. Baradaran Bagheri A, Sadati L, Beyrami A, Fatollahi S, Nouri Khanegah Z, Torkamandi H. Postoperative Skin Complications after Spine Surgery in the Prone Position. Journal of Clinical and Basic Research 2019; 3(3):18-24.
  14. Golmakani N. Comparison and correlation between visual analogue scale and different dimensions of the short form of McGill pain questionnaire in post cesarean pain evaluation. Nursing And Midwifery Journal 2018; 16(9):622-30.
  15. Nickels TJ, Manlapaz MR, Farag E. Perioperative visual loss after spine surgery. World journal of orthopedics 2014; 5(2):100.
  16. Montazer M, Hadadi Z, Ghavami Z, Khanbabaei Gol M. Relationship of Body Mass Index with Chronic Pain after Breast Surgery in Women with Breast Cancer. Iran J Obstet Gynecol Infertil 2019; 22(8):10-8.
  17. DePasse JM, Palumbo MA, Haque M, Eberson CP, Daniels AH. Complications associated with prone positioning in elective spinal surgery. World journal of orthopedics 2015; 6(3):351.
  18. Chung JH, Ahn KR, Park JH, Kim CS, Kang KS, Yoo SH, et al. Lower leg compartment syndrome following prolonged orthopedic surgery in the lithotomy position-A case report. Korean journal of anesthesiology 2010; 59(Suppl):S49.
  19. Sajid MS, Shakir AJ, Khatri K, Baig MK. Lithotomy‐related neurovascular complications in the lower limbs after colorectal surgery. Colorectal Disease 2011; 13(11):1203-13.
  20. Bauer EC, Koch N, Erichsen CJ, Juettner T, Rein D, Janni W, et al. Survey of compartment syndrome of the lower extremity after gynecological operations. Langenbeck's archives of surgery 2014; 399(3):343-8.
  21. Kikuchi T, Maeda H. Two cases of compartment syndrome of the lower extremities during surgery for gynecological malignancies. Journal of anesthesia 2016; 30(3):481-5.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 24, Issue 12
January 2022
Pages 29-34