Stirrups and leg pain

[CDNORRN]

Yesterday I had an incident where 3 patients came back to the PACU complaining of unbearable leg pain. They had lap gyn proceedures done up in swing stirrups/candycanes. I seem to remember this from days gone by and was wondering if others in the OR had encountered this type of upper leg pain related to the use of these stirrups. Their surgical site pain was not the issue and I would petition against using them further if I could get some good solid info regarding their use.

[mikethern]

Let the O.R. manager know. She should monitor that legs are being positioned correctly, and that both legs moved at the same time instead of one at a time.

[CDNORRN]

The problem is not with moving the legs independently, the obgyn is obsessive about position and timing of the movements. I am wondering if the pain might be related to the exteral rotation of the hips accompanined with the lack of support while in the swing stirrups. There don't seem to be the same pain issues with Allen and Yellowfin stirrups. I'd like to be able to present some information to the obgyn to eliminate the use of them completely. Help!

[mikethern]

Talk to your O.R. manager and tell her what's going on. If the patient sues the hospital, then you are going to court. Don't be surprised if the surgeon blames you even if it's not your fault. Make sure you have your own malpractice insurance too.

[ebear, BSN, RN]

It could be that the legs are hyperflexed at the hip resulting in impaired circulatory function to the legs. Is this occurence with the same physician? Allen stirrups do prevent this problem and I agree with mikethern about reporting this to the NM. You may also want to discuss this finding with the GYN's with whom you work. Also, during cases requiring lady partsl retraction (vag hyst) the assistants holding the retractors often gain leverage by resting their arms on the patient's posterior thigh. This further flexes the hip and impairs circulatory, as well as nerve function. You can google "surgical position physiology" where AORN has covered this topic completely.

ebear