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Association between the use of gel pads under patients' knees and the incidence of peroneal neuropathy following liver transplantation

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Singapore Med J 2014; 55(8): 432-435; http://dx.doi.org/10.11622/smedj.2014102
Association between the use of gel pads under patients' knees and the incidence of peroneal neuropathy following liver transplantation

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Kim GS, Yoon JS, Kee R, Shin YH, Ko JS, Gwak MS, Hwang JH, Lee SK
Correspondence: Dr Jin Sun Yoon, medisun74@naver.com

ABSTRACT
INTRODUCTION There have been intermittent reports of peroneal neuropathy (PN) occurring after liver transplantation. Although PN may not be viewed as a serious complication by liver transplant (LT) recipients who require the transplant for survival, PN can significantly reduce quality of life. The incidence of PN appears to have increased after the use of gel pads was introduced. These gel pads, which are placed under patients’ knees during surgery, are used to reduce lower back strain and prevent contact between the peroneal nerve at the fibular head and the hard surface of the operating table. The aim of the present study was to investigate the association, if any, between the use of gel pads and the incidence of PN.
METHODS The medical records of 261 adult LT recipients were retrospectively reviewed. The recipients were divided into gel pad (n = 167) and non-gel pad (n = 94) groups. The incidence and possible risk factors of PN were compared between the two groups.
RESULTS The overall incidence of PN was 8.0% (21/261). The occurrence of PN was significantly higher in the gel pad group than in the non-gel pad group (10.8% vs. 3.2%; p < 0.05). Other possible risk factors were comparable between the two patient groups.
CONCLUSION As the use of gel pads may increase the incidence of PN, we recommend against the use of gel pads under the knees of LT recipients.

Keywords: liver transplantation, patient positioning, peroneal neuropathy
Singapore Med J 2014; 55(8): 432-435; http://dx.doi.org/10.11622/smedj.2014102

http://smj.org.sg/sites/default/files/5508/5508a4.pdf

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