Marinelli Lucio, Mori Laura, Avanti Chiara, Cotellessa Filippo, Fabbri Sabrina, Schenone Cristina, Trompetto Carlo
Division of Clinical Neurophysiology, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Department of Neuroscience (DINOGMI), University of Genoa, Genova, Italy.
Eur J Case Rep Intern Med. 2020 Nov 16;7(12):002039. doi: 10.12890/2020_002039. eCollection 2020.
One of the most feared complications of COVID-19 is respiratory failure caused by acute respiratory distress syndrome. In order to improve oxygenation and survival, patients admitted to intensive care units and intubated may undergo prone position mechanical ventilation. Prolonged prone positioning may cause meralgia paraesthetica due to lateral femoral cutaneous nerve entrapment between the inguinal ligament and the anterior superior iliac spine. Reports of the first two cases have been recently published.
We describe the case of a 52-year-old man with respiratory failure during COVID-19 infection, who underwent prone position ventilation for 16 hours a day over 19 days and developed persistent burning pain and dysaesthesia on the lateral surface of the thigh bilaterally, diagnosed as meralgia paraesthetica.
This is the second report describing meralgia paraesthetica following prone position ventilation in COVID-19. Given the ongoing pandemic and the inevitability of more patients with severe respiratory distress requiring prone position ventilation, this disabling entrapment condition should be considered and possibly prevented.
COVID-19 may require intubation and mechanical ventilation because of respiratory distress.Prone position ventilation improves oxygenation, but may cause lateral femoral cutaneous nerve entrapment and meralgia paraesthetica.Medical personnel should be aware of the risk of meralgia paraesthetica as a disabling condition potentially affecting more patients as the COVID-19 pandemic persists.
新型冠状病毒肺炎（COVID-19）最可怕的并发症之一是急性呼吸窘迫综合征所致的呼吸衰竭。为改善氧合及提高生存率，入住重症监护病房并接受气管插管的患者可能会接受俯卧位机械通气。长时间俯卧位可能因股外侧皮神经在腹股沟韧带和髂前上棘之间受压而导致感觉异常性股痛。最近已发表了前两例相关报告。
我们描述了一名52岁男性COVID-19感染期间发生呼吸衰竭的病例，其接受了为期19天、每天16小时的俯卧位通气，之后双侧大腿外侧出现持续灼痛和感觉异常，被诊断为感觉异常性股痛。
这是第二例描述COVID-19患者俯卧位通气后发生感觉异常性股痛的报告。鉴于疫情仍在持续，且更多严重呼吸窘迫患者不可避免地需要进行俯卧位通气，应考虑并可能预防这种致残性压迫情况。
COVID-19可能因呼吸窘迫而需要气管插管和机械通气。俯卧位通气可改善氧合，但可能导致股外侧皮神经受压和感觉异常性股痛。随着COVID-19大流行持续，医务人员应意识到感觉异常性股痛作为一种致残状况可能影响更多患者的风险。
