The objective of the study is to see if using candy cane stirrups increases the incidence of lower extremity peripheral neuropathy compared to using boot stirrups in women undergoing surgery that requires dorsal lithotomy placement.
Patients who underwent gynecologic surgery for benign reasons lasting 60 minutes or longer in the lithotomy position were included in this retrospective cohort analysis. Patients with a history of neurologic illness were not eligible. The medical record was searched for stirrup type, demographics, medical history, surgical variables, and pertinent outcomes. During the 6-week postoperative visit, postoperative neuropathy was found in clinical diagnosis or in physician records. The Student’s t-test, 2 test, or Fisher exact test were used to compare patient characteristics and results. To account for additional clinical factors linked with the outcome at P.1, logistic regression analysis was utilized.
There were 2,449 patients in the research, 1,838 with boots and 611 with candy cane stirrups. Women in boot stirrups were younger (mean age 45.6 years [SD 13.5] vs 55.9 [SD 15.7] years; P<.001), heavier (mean body mass index [BMI] 31.5 [SD 8.7] vs 29.6 [SD 7.0]; P<.001), more likely to smoke (n=396 [21.5%] vs n=105 [17.2%]; P=.021), and had a longer surgery duration (mean 176.5 minutes [SD 90.0] vs 145.3 [SD 63.9] minutes; P<.001). Diabetes levels did not differ across groups. Neuropathy was less common in the boot cohort (n=29, 1.6%, 95% CI 1.1–2.3%) compared to the candy cane cohort (n=21, 3.4%, 95% CI 2.1–5.2%) (P=.008). Only candy cane stirrup type adjusted odds ratio [aOR] 2.87, 95% CI 1.59–5.19) and surgical time (per hour) (aOR 1.40, 95% CI 1.20–1.63) were independently linked with postoperative neuropathy after controlling for age, BMI, smoking, anesthetic type, and surgical time.
When compared to boot stirrups, candy cane stirrups are associated with a considerably higher incidence of lower extremities postoperative neuropathy in women following benign gynecologic surgery.