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Intermittent pneumatic compression prevents venous stasis in the lower extremities in the lithotomy position

[Une compression pneumatique intermittente prévient l'insuffisance veineuse aux membres inférieurs en position gynécoloqique]

Shinji Kohro, MD PhD^*, Michiaki Yamakage, MD PhD, Toshiyuki Takahashi, MD^*, Mitsu Kondo, MD^*, Koichi Ota, MD PhD^* and Akiyoshi Namiki, MD PhD

^* From the Departments of Anesthesia Ebetsu Municipal Hospital Ebetsu, and
the Sapporo Medical University, School of Medicine, Sapporo Hokkaido Japan.

Address correspondence to: Dr. Michiaki Yamakage, Department of Anesthesiology, Sapporo Medical University, School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. Phone: +81-11-611-2111, ext. 3568; Fax: +81-11-631-9683; E-mail: yamakage{at}sapmed.ac.jp

Purpose: To investigate the interactions of a new lithotomy positioning device (LPD) with two intermittent pneumatic compression (IPC) devices by measuring femoral venous flow velocity.

Methods: Subjects were divided into three groups: 1) supine position as a control, 2) lithotomy position using a conventional LPD, and 3) lithotomy position using a new LPD, Levitator^TM. These three groups were further divided in two according to the type of IPC device used: AV-impulse^TM (rapid IPC) and SeQuel^TM (standard IPC). Peak femoral venous flow velocity was measured by using an ultrasonic echo diagnostic device. Data were analyzed by one-way ANOVA with Fisher's test or by the unpaired two-tailed t test.

Results: Moving to the conventional lithotomy position from the supine position, venous flow velocity was decreased by 38% in both IPC device groups. Even when the new LPD was used to support the lithotomy position, the flow velocity was decreased by 24%, but the velocity was significantly higher than in the conventional lithotomy position. Both rapid and standard IPC devices increased flow velocity to 77% and 107% (first compression) and to 71% and 84% (fifth compression) of the control values during compression, respectively. In the lithotomy position group using the new LPD, similar increases in flow were seen with the use of IPC devices.

Conclusion: Both rapid and standard IPC devices are useful for maintaining venous flow of the lower extremities in the lithotomy position.