ROM intra-op for long cases

We just had a Grand Rounds presentation at work that mentioned this. The GYN MD presenting said that during long surgery using standard lithotomy position (as OP asked) that he wants the patient's legs lowered after 90-120 minutes to improve circulation. He didn't specify whether this was done within the sterile field or by breaking the drapes down and re-draping afterward.

Gee - after 25 years, I don't believe I've ever seen a case with a patient in lithotomy for more than 60-70 minutes. I work with one surgeon who uses extreme lithotomy he's done in 45 minutes. No one should be in lithotomy for long periods but the new leg holders are much kinder to circulation than the old candy canes. I do massage patients elbows and scalps when the case permits - once an hour. But I'm anesthesia and would not take kindly to anyone else massaging the patient. Positioning is ulltimately our job and I believe that we are the ones usually sued for nerve injuries.