Abstract
Purpose
To investigate the interactions of a new lithotomy positioning device (LPD) with “two intermittent pneumatic compression (IPC) devices by measuring femoral venous flow velocity.
Methods
Subjects were divided into three groups: I) supine position as a control, 2) lithotomy position using a conventional LPD, and 3) lithotomy position using a new LPD, Levitator™. These three groups were further divided in two according to the type of IPC device used: AV-impulse™ (rapid IPC) and SeQuel™ (standard IPC). Peak femoral venous flow velocity was measured by using an ultrasonic echo diagnostic device. Data were analyzed by one-way ANOVA with Fisher’s test or by the unpaired two-tailed t test.
Results
Moving to the conventional lithotomy position from the supine position, venous flow velocity was decreased by 38% in both IPC device groups. Even when the new LPD was used to support the lithotomy position, the flow velocity was decreased by 24%, but the velocity was significantly higher than in the conventional lithotomy position. Both rapid and standard IPC devices increased flow velocity to 77% and 107% (first compression) and to 71% and 84% (fifth compression) of the control values during compression, respectively. In the lithotomy position group using the new LPD, similar increases in flow were seen with the use of IPC devices.
Conclusion
Both rapid and standard IPC devices are useful for maintaining venous flow of the lower extremities in the lithotomy position.
Résumé
Objectif
Rechercher les interactions d’un nouvel appareil pour position gynécologique (APG) comportant deux dispositifs à compression pneumatique intermittente (CPI) en mesurant la vitesse circulatoire de la veine fémorale.
Méthode
Les sujets ont été divisés en trois groupes : 1) témoins en décubitus dorsal, 2) position gynécologique avec un APG traditionnel et 3) position gynécologique avec un nouvel APG, Levitator™. Ces trois groupes ont été subdivisés en deux selon le type de CPI utilisée : AV-impulse™ (CPI rapide) et SeQuel™ (CPI régulier). La vitesse circulatoire fémorale maximale a été mesurée grâce à l’échographie diagnostique. Les données ont été soumises à l’analyse de variance à une voie et le test de Fisher ou le test bilatéral pour série non appariées.
Résultats
En passant du décubitus dorsal à la position gyné-cologique traditionnelle, la vitesse circulatoire veineuse a diminué de 38 % avec l’utilisation des deux types de CPI. Même avec le nouvel APG, la vitesse circulatoire a baissé de 24 %, mais elle a été signifcativement plus élevée qu’en position gynécologique traditionnelle. Les deux dispositifs de CPI, rapide et régulière, ont fait respectivement augmenter la vitesse circulatoire à 77% et 107% (première compression) et à 71% et 84% (cinquième compression) des valeurs témoins pendant la compression. Avec le nouvel APG, des augmentations similaires ont été observées avec l’usage des deux dispositifs de CPI.
Conclusion
Les deux dispositifs de CPI rapide et régulière peuvent maintenir une vitesse circulatoire veineuse des membres inférieurs en position gynécologique.
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Supported in part by an incentive grant (Y-058, 1999) for research from the Hokksaitec Foundation, Sapporo, Japan.
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Kohro, S., Yamakage, M., Takahashi, T. et al. Intermittent pneumatic compression prevents venous stasis in the lower extremities in the lithotomy position. Can J Anesth 49, 144–147 (2002). https://doi.org/10.1007/BF03020486
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DOI: https://doi.org/10.1007/BF03020486