[Postoperative palsies of the common peroneal nerve and the tibial nerve associated with lateral position].
A 36-year-old woman with systemic lupus erythematous secondary to diabetes underwent right total hip arthroplasty in the left lateral position. An epidural catheter was inserted at the L1-2 interspace and placed cephalad prior to induction of general anesthesia. After the operation, she complained of numbness on the dorsum and plantar of the left foot and was unable to dorsiflex and plantarflex the ankle. The symptoms persisted after discontinuation of the epidural infusion of a local anesthetic, and they became exacerbated after the second operation in the left lateral position. Electromyography and nerve conduction study revealed palsies of the left common peroneal nerve and the tibial nerve due to local compression and also showed mononeuritis multiplex. Fortunately, the symptoms disappeared completely eight months post-operation. It should be noted that lateral positioning may be at a substantial risk of perioperative peripheral neuropathy in patients with diseases causing neural disorder.