Perioperative neuropathic and positional problems: literature review
- Authors: Svirskii D.A.1, Paromov K.V.2, Sokolova M.M.1,2, Kuzkov V.V.1,2, Kirov M.Y.1,2
-
Affiliations:
- Northern State Medical University
- Volosevich First City Clinical Hospital
- Issue: Vol 17, No 4 (2023)
- Pages: 217-230
- Section: Reviews
- URL: https://rjraap.com/1993-6508/article/view/622889
- DOI: https://doi.org/10.17816/RA622889
- ID: 622889
Cite item
Abstract
At present, an increasing number of specialists prefer the fast-track surgery concept. One of the significant perioperative complications that can affect the rate and quality of postoperative rehabilitation is the development of neuropathy, which can be the result of improper patient positioning on the operating table, and direct intraoperative damage to the nerve / trunk / plexus. Physical (mechanical compression, stretching, and partial / complete intersection of the nerve with a needle, scalpel, or electrode) and chemical (toxicity of local anesthetics and chemically active liquid effects) mechanisms for neuropathy formation can be described. To prevent the development of a neurological deficit, both the anesthesiologist and surgeon must take all the necessary measures to prevent neuropathies and begin appropriate treatment as soon as possible in the case of its occurrence. This article discusses the anatomy, physiology, and pathophysiology of the peripheral nerve, mechanisms of compression-ischemic neuropathy formation, and perioperative positional problems. Existing recommendations for the treatment of peripheral neuropathic were assessed and proposed for use not only with conservative therapy methods but also with interventional methods for the treatment of established perioperative neurological complications. A summary table of the possible clinical manifestations of postoperative neuropathic is presented.
Full Text
About the authors
Dmitrii A. Svirskii
Northern State Medical University
Email: dsvirskiy@mail.ru
ORCID iD: 0000-0001-5798-9209
SPIN-code: 9740-9109
MD, Cand. Sci. (Med.), associate professor
Russian Federation, 51 Troitsky Ave., 163069, ArkhangelskKonstantin V. Paromov
Volosevich First City Clinical Hospital
Email: kp82@mail.ru
ORCID iD: 0000-0002-5138-3617
SPIN-code: 9673-1896
MD, Cand. Sci. (Med.), anesthesiologist-resuscitator
Russian Federation, ArkhangelskMaria M. Sokolova
Northern State Medical University; Volosevich First City Clinical Hospital
Email: sokolita1@yandex.ru
ORCID iD: 0000-0002-6705-5124
SPIN-code: 3499-3430
MD, Cand. Sci. (Med.), associate professor
Russian Federation, Arkhangelsk; ArkhangelskVsevolod V. Kuzkov
Northern State Medical University; Volosevich First City Clinical Hospital
Email: v_kuzkov@mail.ru
ORCID iD: 0000-0002-8191-1185
SPIN-code: 6813-2450
MD, Dr. Sci. (Med.), department professor, anesthesiologist-resuscitator
Russian Federation, Arkhangelsk; ArkhangelskMikhail Yu. Kirov
Northern State Medical University; Volosevich First City Clinical Hospital
Author for correspondence.
Email: mikhail_kirov@hotmail.com
ORCID iD: 0000-0002-4375-3374
SPIN-code: 2025-8162
MD, Dr. Sci. (Med.), Professor, Corresponding member of RAS, department head
Russian Federation, Arkhangelsk; ArkhangelskReferences
- Fedorov SA, Kichin VV, Sungurov VA, Likhvantsev VV. Positional disorders in the practice of an anesthesiologist Annals of Critical Care. 2014;(1):20–25. (In Russ).
- Chui J, Murkin JM, Posner KL, Domino KB. Perioperative Peripheral Nerve Injury After General Anesthesia: A Qualitative Systematic Review. Anesth Analg. 2018;127(1):134–143. doi: 10.1213/ANE.0000000000003420
- Baron R. Peripheral neuropathic pain: from mechanisms to symptoms. Clin J Pain. 2000;16(2 Suppl):S12–S20. doi: 10.1097/00002508-200006001-00004
- Garg B, Bansal T, Mehta N, Sharan AD. Patient Positioning in Spine Surgery: What Spine Surgeons Should Know? Asian Spine J. 2023;17(4):770–781. doi: 10.31616/asj.2022.0320
- Rojas J, Familiari F, Bitzer A, et al. Patient Positioning in Shoulder Arthroscopy: Which is Best? Joints. 2019;7(2):46–55. doi: 10.1055/s-0039-1697606
- Kim HR, Kim SH. Perioperative and anesthetic management of patients with rheumatoid arthritis. Korean J Intern Med. 2022;37(4):732–739. doi: 10.3904/kjim.2021.555
- Petrova ES, Kolos EA. Current Views on Perineurial Cells: Unique Origin, Structure, Functions. Journal of Evolutionary Biochemistry and Physiology. 2022;58(1):3–23. (In Russ). doi: 10.31857/S0044452922010053
- Gordon T. Peripheral Nerve Regeneration and Muscle Reinnervation. Int J Mol Sci. 2020;21(22):8652. doi: 10.3390/ijms21228652
- Saporta MA, Bacha A, Shy ME. Chapter 11 — Peripheral neuropathies. Thoughts on teaching about the neurobiology of diseases section available at the beginning of the book and Index terms are available at the end of the book. Zigmond MJ, Wiley CA, Chesselet MF, editors. Neurobiology of Brain Disorders (2nd Edition). San Diego: Academic Press; 2023. P. 165–184. doi: 10.1016/B978-0-323-85654-6.00006-X
- Winfree CJ, Kline DG. Intraoperative positioning nerve injuries. Surg Neurol. 2005;63(1):5–18;discussion 18. doi: 10.1016/j.surneu.2004.03.024
- Reina MA, Sala-Blanch X, Arriazu R, Machés F. Chapter 7 — Microscopic Morphology and Ultrastructure of Human Peripheral Nerves. Tubbs RS, Rizk E, Shoja MM, et al, editors. Nerves and Nerve Injuries. San Diego: Academic Press; 2015. P. 91–106. doi: 10.1016/B978-0-12-410390-0.00007-X
- Zhang H, Zhang Z, Lin H. Research progress on the reduced neural repair ability of aging Schwann cells. Front Cell Neurosci. 2023;(17):1228282. doi: 10.3389/fncel.2023.1228282
- Svirskii DA, Antipin EE, Bochkareva NA, et al. Cryoanalgesia. Review. Annals of Critical Care. 2020;(4):58–73. (In Russ). doi: 10.21320/1818-474X-2020-4-58-73
- Waluyo Y, Artika SR, Insani Nanda Wahyuni, et al. Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review. J Rehabil Med. 2023;(55):jrm00372. doi: 10.2340/jrm.v55.2572
- Radkowski P, Fadrowska-Szleper M, Podhorodecka K, Mieszkowski M. Neurological Complications of Regional Anesthesia: An Updated Review with Clinical Guidelines. Med Sci Monit. 2023;(29):e940399. doi: 10.12659/MSM.940399
- Hewson DW, Kurien T, Hardman JG. Postoperative ulnar neuropathy: a systematic review of evidence with narrative synthesis. Br J Anaesth. 2023;131(1):135–149. doi: 10.1016/j.bja.2023.04.010
- Katayama S, Mori K, Pradere B, et al. Influence of steep Trendelenburg position on postoperative complications: a systematic review and meta-analysis. J Robot Surg. 2022;16(6):1233–1247. doi: 10.1007/s11701-021-01361-x
- Iftikhar H, Ahmed SK, Abbas SA, et al. Optimum Degree of Head Elevation / Reverse Trendelenburg Position for Sinus Surgery: Systematic Review. Am J Rhinol Allergy. 2021;35(3):302–307. doi: 10.1177/1945892420954794
- De Cassai A, Geraldini F, Zarantonello F, et al. A practical guide to patient position and complication management in neurosurgery: a systematic qualitative review. Br J Neurosurg. 2022;36(5):583–593. doi: 10.1080/02688697.2021.1995593
- Toruńska E, Owczarek-Konopka M, Konopka M, et al. Brachial plexopathy as a result of anatomical prone position in COVID-19 patients-Systematic review. Clin Anat. 2023. doi: 10.1002/ca.24112. Epub ahead of print.
- Kamel I, Zhao H, Koch SA, et al. The Use of Somatosensory Evoked Potentials to Determine the Relationship Between Intraoperative Arterial Blood Pressure and Intraoperative Upper Extremity Position-Related Neurapraxia in the Prone Surrender Position During Spine Surgery: A Retrospective Analysis. Anesth Analg. 2016;122(5):1423–1433. doi: 10.1213/ANE.0000000000001121
- Bjøro B, Mykkeltveit I, Rustøen T, et al. Intraoperative peripheral nerve injury related to lithotomy positioning with steep Trendelenburg in patients undergoing robotic-assisted laparoscopic surgery — A systematic review. J Adv Nurs. 2020;76(2):490–503. doi: 10.1111/jan.14271
- McKechnie T, Lee Y, Springer JE, et al. Prone Compared With Lithotomy for Abdominoperineal Resection: A Systematic Review and Meta-analysis. J Surg Res. 2019;(243):469–480. doi: 10.1016/j.jss.2019.07.005
- Katz S, Arish N, Rokach A, et al. The effect of body position on pulmonary function: a systematic review. BMC Pulm Med. 2018;18(1):159. doi: 10.1186/s12890-018-0723-4
- Pozuelo-Carrascosa DP, Cobo-Cuenca AI, Carmona-Torres JM, et al. Body position for preventing ventilator-associated pneumonia for critically ill patients: a systematic review and network meta-analysis. J Intensive Care. 2022;10(1):9. doi: 10.1186/s40560-022-00600-z
- Tourinho-Barbosa RR, Tobias-Machado M, Castro-Alfaro A, et al. Complications in robotic urological surgeries and how to avoid them: A systematic review. Arab J Urol. 2018;16(3):285–292. doi: 10.1016/j.aju.2017.11.005
- Tufegdzic B, Lamperti M, Siyam A, Roser F. Air-embolism in the semi-sitting position for craniotomy: A narrative review with emphasis on a single centers experience. Clin Neurol Neurosurg. 2021;(209):106904. doi: 10.1016/j.clineuro.2021.106904
- Wright JM, Gerges C, Shammassian B, et al. Prone Position Ventilation in Neurologically Ill Patients: A Systematic Review and Proposed Protocol. Crit Care Med. 2021;49(3):e269–e278. doi: 10.1097/CCM.0000000000004820
- Yahanda AT, Chicoine MR. Paralysis Caused by Spinal Cord Injury After Posterior Fossa Surgery: A Systematic Review. World Neurosurg. 2020;(139):151–157. doi: 10.1016/j.wneu.2020.04.016
- Mojica JJ, Ocker A, Barrata J, Schwenk ES. Anesthesia for the Patient Undergoing Shoulder Surgery. Clin Sports Med. 2022;41(2):219–231. doi: 10.1016/j.csm.2021.11.004
- Isagulyan EI, Tomsky AA, Shabalov VA. Clinical guidelines “Surgical treatment of chronic neuropathic pain syndrome” [Internet]. Moscow; 2015 [cited 2023 Nov 23]. Available from: https://ruans.org/Text/Guidelines/neuropathic_pain.pdf (In Russ).
- Danilov AB, Davydov OS. Principles and algorithms for the treatment of neuropathic pain. RMJ. 2008 [cited 2023 Nov 23];11. Available from: http://www.rmj.ru/articles/bolevoy_sindrom/Principy_i_algoritmy_lecheniya_neyropaticheskoy_boli/. (In Russ).
- Davydov OS, Yakhno NN, Kukushkin ML, et al. Neuropathic pain: clinical guidelines on the diagnostics and treatment from the Russian Association for the Studying of Pain. Russian Journal of Pain. 2018;(4):5–41. (In Russ). doi: 10.25731/RASP.2018.04.025
- Bates D, Schultheis BC, Hanes MC, et al. A Comprehensive Algorithm for Management of Neuropathic Pain. Pain Med. 2019;20(Suppl 1):S2–S12. doi: 10.1093/pm/pnz075
- Farag S, Rosen L, Ascher-Walsh C. Comparison of the Memory Foam Pad Versus the Bean Bag with Shoulder Braces in Preventing Patient Displacement during Gynecologic Laparoscopic Surgery. J Minim Invasive Gynecol. 2018;25(1):153–157. doi: 10.1016/j.jmig.2017.09.009
- Cornelius J, Mudlagk J, Afferi L, et al. Postoperative peripheral neuropathies associated with patient positioning during robot-assisted laparoscopic radical prostatectomy (RARP): A systematic review of the literature. Prostate. 2021;81(7):361–367. doi: 10.1002/pros.24121
- Rui L, Xu G, Lv X, Ma Z. A Comprehensive Protocol to Prevent Brachial Plexus Injury During Ankylosing Spondylitis Surgery. J Perianesth Nurs. 2018;33(6):908–914. doi: 10.1016/j.jopan.2017.09.005
- Das D, Propst K, Wechter ME, Kho RM. Evaluation of Positioning Devices for Optimization of Outcomes in Laparoscopic and Robotic-Assisted Gynecologic Surgery. J Minim Invasive Gynecol. 2019;26(2):244.e1–252.e1. doi: 10.1016/j.jmig.2018.08.027
- Greenberg JA. The Pink Pad — Pigazzi Patient Positioning SystemTM. Rev Obstet Gynecol. 2013;6(2):97.
- Treszezamsky AD, Fenske S, Moshier EL, Ascher-Walsh CJ. Neurologic injury and patient displacement in gynecologic laparoscopic surgery using a beanbag and shoulder supports. Int J Gynaecol Obstet. 2018;140(1):26–30. doi: 10.1002/ijgo.12325
- Malhotra A, Gupta V, Abraham M, et al. Quantifying the Amount of Bleeding and Associated Changes in Intra-Abdominal Pressure and Mean Airway Pressure in Patients Undergoing Lumbar Fixation Surgeries: A Comparison of Three Positioning Systems. Asian Spine J. 2016;10(2):199–204. doi: 10.4184/asj.2016.10.2.199
- Wechter ME, Kho RM, Chen AH, et al. Preventing slide in Trendelenburg position: randomized trial comparing foam and gel pads. J Robot Surg. 2013;7(3):267–271. doi: 10.1007/s11701-012-0370-3
- Nikitin SS, Murtazina AF, Druzhinin DS. Conduction block as an electrophysiological phenomenon: a review of the literature. Neuromuscular Diseases. 2019;9(1):12–23. (In Russ). doi: 10.17650/2222-8721-2019-9-1-12-23
- Bromberg MB, Franssen H. Practical rules for electrodiagnosis in suspected multifocal motor neuropathy. J Clin Neuromuscul Dis. 2015;16(3):141–152. doi: 10.1097/CND.0000000000000044
- Grishina DA, Suponeva NA, Pavlov EV, Savitskaya NG. Anomalous innervations: variations and typical electromyography pattern. Neuromuscular Diseases. 2016;6(2):10–19. (In Russ). doi: 10.17650/2222-8721-2016-6-2-10-19
- Tavee J. Nerve conduction studies: Basic concepts. Handb Clin Neurol. 2019;(160):217–224. doi: 10.1016/B978-0-444-64032-1.00014-X
- Zaki HA, Shaban E, Salem W, et al. A Comparative Analysis Between Ultrasound and Electromyographic and Nerve Conduction Studies in Diagnosing Carpal Tunnel Syndrome (CTS): A Systematic Review and Meta-Analysis. Cureus. 2022;14(10):e30476. doi: 10.7759/cureus.30476
- Wee TC, Simon NG. Ultrasound elastography for the evaluation of peripheral nerves: A systematic review. Muscle Nerve. 2019;60(5):501–512. doi: 10.1002/mus.26624
- Maleki MS, Zamani Z, Amiri R, et al. Pregabalin in patients with post-traumatic peripheral neuropathic pain: A meta-analysis of randomized controlled trials. Pain Pract. 2023;23(6):595–602. doi: 10.1111/papr.13221
- Derry S, Bell RF, Straube S, et al. Pregabalin for neuropathic pain in adults. Cochrane Database Syst Rev. 2019;1(1):CD007076. doi: 10.1002/14651858.CD007076.pub3
- Onakpoya IJ, Thomas ET, Lee JJ, et al. Benefits and harms of pregabalin in the management of neuropathic pain: a rapid review and meta-analysis of randomised clinical trials. BMJ Open. 2019;9(1):e023600. doi: 10.1136/bmjopen-2018-023600
- Cheng ETL, Cheik-Hussein M, Lin N, et al. A meta-epidemiological study on the reported treatment effect of pregabalin in neuropathic pain trials over time. PloS One. 2023;18(1):e0280593. doi: 10.1371/journal.pone.0280593
- Lee JH, Koutalianos EP, Leimer EM, et al. Intravenous Lidocaine in Chronic Neuropathic Pain: A Systematic Review. Clin J Pain. 2022;38(12):739–748. doi: 10.1097/AJP.0000000000001080
- Moore SG. Intravenous Dexamethasone as an Analgesic: A Literature Review. AANA J. 2018;86(6):488–493.
- Ovechkin AM, Becker AA. Intravenous lidocaine infusion as a perspective component of multimodal analgesia, which affects on early postoperative outcome. Regional Anesthesia and Acute Pain Management. 2017;11(2):73–83. (In Russ). doi: 10.17816/RA42835
- McMullin PR, Hynes AT, Arefin MA, et al. Infusion Therapy in the Treatment of Neuropathic Pain. Curr Pain Headache Rep. 2022;26(9):693–699. doi: 10.1007/s11916-022-01071-5
- Felker EYu, Zabolotskii DV, Koriachkin VA, et al. Efficacy and safety of intravenous infusion of lidocaine in children. Russian Journal of Anesthesiology and Reanimatology. 2021;(2):50–55. (In Russ). (In Russ). doi: 10.17116/anaesthesiology202102150
- Jordan B, Jahn F, Beckmann J, et al. Calcium and Magnesium Infusions for the Prevention of Oxaliplatin-Induced Peripheral Neurotoxicity: A Systematic Review. Oncology. 2016;90(6):299–306. doi: 10.1159/000445977
- Abdel-Wahab AH, Abd Alla ES, Abd El-Azeem T. Effect of intravenous dexamethasone on the duration of hyperbaric bupivacaine spinal anesthesia in lower abdominal surgery, Randomized controlled trial. BMC Anesthesiol. 2023;23(1):323. doi: 10.1186/s12871-023-02282-y
- Buntragulpoontawee M, Chang KV, Vitoonpong T, et al. The Effectiveness and Safety of Commonly Used Injectates for Ultrasound-Guided Hydrodissection Treatment of Peripheral Nerve Entrapment Syndromes: A Systematic Review. Front Pharmacol. 2020;(11):621150. doi: 10.3389/fphar.2020.621150
- Lam KHS, Hung CY, Chiang YP, et al. Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms. J Pain Res. 2020;(13):1957–1968. doi: 10.2147/JPR.S247208
- Zheng Y, Liu CW, Hui Chan DX, et al. Neurostimulation for Chronic Pain: A Systematic Review of High-Quality Randomized Controlled Trials With Long-Term Follow-Up. Neuromodulation. 2023;26(7):1276–1294. doi: 10.1016/j.neurom.2023.05.003
- Wang C, Dou Z, Yan M, Wang B. Efficacy and Safety of Pulsed Radiofrequency in Herpes Zoster Related Trigeminal Neuralgia: A Systematic Review and Meta-Analysis. J Pain Res. 2023;(16):341–355. doi: 10.2147/JPR.S396209
- Jin MY, Weaver TE, Farris A, et al. Neuromodulation for Peripheral Nerve Regeneration: Systematic Review of Mechanisms and In Vivo Highlights. Biomedicines. 2023;11(4):1145. doi: 10.3390/biomedicines11041145
- van Gorp EJJAA, Adang EMM, Gültuna I, et al. Cost-Effectiveness Analysis of Peripheral Nerve Field Stimulation as Add-On Therapy to Spinal Cord Stimulation in the Treatment of Chronic Low Back Pain in Failed Back Surgery Syndrome Patients. Neuromodulation. 2020;23(5):639–645. doi: 10.1111/ner.13032
- Deer TR, Pope JE, Lamer TJ, et al. The Neuromodulation Appropriateness Consensus Committee on Best Practices for Dorsal Root Ganglion Stimulation. Neuromodulation. 2019;22(1):1–35. doi: 10.1111/ner.12845
- Moisset X, Bouhassira D, Avez Couturier J, et al. Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations. Rev Neurol (Paris). 2020;176(5):325–352. doi: 10.1016/j.neurol.2020.01.361