Lower limb heamodynamics during prolonged head-down tilt surgery
Research type
Research Study
Full title
“The effects of prolonged head-down tilt lithotomy position in lower limb haemodynamics”
IRAS ID
287464
Contact name
Maria Perissiou
Contact email
Sponsor organisation
University of Portsmouth
Clinicaltrials.gov Identifier
Duration of Study in the UK
years, 18 months, 0 days
Research summary
The head down tilt lithotomy position is commonly used during surgery for colorectal, gynaecological and urological procedures as it provides a greater access to the pelvis. It involves the patient lying on their back with their head lowered (by 15 degrees) compared to their legs, which are flexed by 90 degrees at the hips and the knees bent at 70 to 90 degrees. However, staying in this position for long periods of time can sometimes severely damage the tissues and the nerves of the calf muscles because blood flow in the muscles is reduced. This phenomenon is called Well Leg Compartment Syndrome (WLCS) and if it is not diagnosed quickly can cause severe complications and sometimes even death. Unfortunately, because the individual is anaesthetised, the diagnosis is delayed in many cases. To date, there are very few studies exploring the parameters leading to this syndrome during surgery. In an effort to better understand the mechanisms that lead to WLSC development during surgery and thereby improve the ability to prevent, as well as to facilitate early diagnosis of this complication, we aim to measure the parameters thought to contribute to this complication. Therefore, we will measure the oxygen and blood flow provided to the calf muscle during prolonged pelvic surgery in 25 individuals placed in a head down tilt lithotomy position. We will also collect blood samples in order to measure biological markers that contribute to the development of WLCS.
REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
20/EM/0286
Date of REC Opinion
18 Dec 2020
REC opinion
Further Information Favourable Opinion