PD28-07 DOES TAPING THE PATIENT TO THE OR TABLE DURING MINIMALLY INVASIVE SURGERY INCREASE THE RISK OF PRESSURE RELATED COMPLICATIONS?

Abstract

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety I (PD28)1 Sep 2021PD28-07 DOES TAPING THE PATIENT TO THE OR TABLE DURING MINIMALLY INVASIVE SURGERY INCREASE THE RISK OF PRESSURE RELATED COMPLICATIONS? Joshua D Belle, Mohamed Keheila, Akin S Amasyali, Jason Groegler, Linnea Burke, Mohammad Hajiha, and D. Duane Baldwin Joshua D BelleJoshua D Belle More articles by this author , Mohamed KeheilaMohamed Keheila More articles by this author , Akin S AmasyaliAkin S Amasyali More articles by this author , Jason GroeglerJason Groegler More articles by this author , Linnea BurkeLinnea Burke More articles by this author , Mohammad HajihaMohammad Hajiha More articles by this author , and D. Duane BaldwinD. Duane Baldwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002029.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Rhabdomyolysis and neuropraxia are potential complications of positioning for minimally invasive surgical procedures. Patients in the modified lateral decubitus position utilized for laparoscopic renal surgery are routinely secured to the bed with tape to allow tilting to near supine and lateral decubitus positions. The effect of this taping upon effective patient weight and subsequent risk of rhabdomyolysis and neuropraxia has not been determined. The purpose of this study is to determine the effect of taping upon effective patient weight and subjective comfort. METHODS: A prospective, randomized study employed 30 subjects (14 male, 16 female) positioned in 45-degree modified right lateral decubitus position and secured to the bed using 3” cloth tape in a manner identical to laparoscopic and robotic renal surgery in our institution. Subjects were positioned in modified lateral decubitus (45 degrees) with and without tape, supine (0 degrees) with tape, and right lateral decubitus (90 degrees) with tape (in reference to the floor; Figure 1). An XSENSOR Bluetooth high-accuracy pressure sensor was used to record contact pressures under the upper body. In addition, subjects rated their breathing and overall comfort on a Likert scale (1-10; 10 most comfortable). Data analysis was performed using ANOVA and Mann-Whitney U-tests. Significance was set at p<0.05. RESULTS: After taping, the average baseline pressure (0.41 psi) of all subjects increased by 12.3%, 12.2%, and 9.5%, in the 0, 45, and 90 degree positions respectively. Taping increased the pressure more in patients with BMI >25 (0.50 psi) compared to those with BMI <25 (0.44 psi; p=0.011). The angle of tilt (0, 45 or 90) did not significantly alter the pressure following taping. Taping had no effect upon overall comfort score, but significantly decreased breathing comfort (9.3 vs. 9.9; p<0.05). CONCLUSIONS: This study demonstrates that taping substantially increases the patient’s effective weight and may subsequently increase the risk of rhabdomyolysis and neuropraxia. Future studies should develop taping strategies that do not increase the effective patient weight or alternative methods for securing the patient to the bed. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e523-e523 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua D Belle More articles by this author Mohamed Keheila More articles by this author Akin S Amasyali More articles by this author Jason Groegler More articles by this author Linnea Burke More articles by this author Mohammad Hajiha More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement Loading ...