Mizuno Ju, Namba Chikara, Takahashi Toru
Masui. 2014 Oct;63(10):1167-71.
We investigated external pressure on peroneal nerve tract coming in contact with two kinds of leg holders using pressure distribution measurement system BIG- MAT® (Nitta Corp., Osaka) in the lithotomy position Peak contact (active) pressure at the left fibular head region coming in contact with knee-crutch-type leg holder M® (Takara Belmont Corp., Osaka), which supports the left popliteal fossa, was 78.0 ± 26.4 mmHg. On the other hand, peak contact pressure at the left lateral lower leg region coming in contact with boot-support-type leg holder Bel Flex® (Takara Belmont Corp., Osaka), which supports the left lower leg and foot was 26.3±7.9 mmHg. These results suggest that use of knee-crutch-type leg holder is more likely to induce common peroneal nerve palsy at the fibular head region, but use of boot-support-type leg holder dose not easily induce superficial peroneal nerve palsy at the lateral lower leg region, because capillary blood pressure is known to be 32 mmHg. Safer holders for positioning will be developed to prevent nerve palsy based on the analysis of chronological change in external pressure using BIG-MAT® system during anesthesia.
我们使用压力分布测量系统BIG - MAT®(日本新田公司,大阪),在截石位研究了与两种腿部固定器接触时腓总神经束所受的外部压力。与支撑左腘窝的膝托型腿部固定器M®(日本宝峨公司,大阪)接触的左腓骨头区域的峰值接触(有效)压力为78.0±26.4 mmHg。另一方面,与支撑左小腿和足部的靴型支撑式腿部固定器Bel Flex®(日本宝峨公司,大阪)接触的左小腿外侧区域的峰值接触压力为26.3±7.9 mmHg。这些结果表明,使用膝托型腿部固定器更有可能在腓骨头区域诱发腓总神经麻痹,但使用靴型支撑式腿部固定器不容易在小腿外侧区域诱发腓浅神经麻痹,因为已知毛细血管血压为32 mmHg。基于在麻醉期间使用BIG - MAT®系统对外部压力随时间变化的分析,将开发更安全的定位固定器以预防神经麻痹。