https://doi.org/10.4081/ecj.2022.10310
A case of meralgia paresthetica caused by prone positioning in a COVID-19 patient with acute respiratory distress syndrome
Submitted: 1 December 2021
Accepted: 21 December 2021
Published: 29 March 2022
Accepted: 21 December 2021
Abstract Views: 676
PDF: 220
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
COVID-19 critically ill patients usually require prone positioning for the treatment of respiratory failure caused by Acute Respiratory Distress Syndrome (ARDS). Prone position provides a better ventilation-perfusion compatibility, resulting in a significant improvement in oxygenation and a decrease in mortality, but prolonged prone positioning may cause Meralgia Paresthetica (MP), one of the most common mononeuropathies of the lower limb. The early diagnosis of MP is crucial to avoid a permanent damage with pain and disability, and to start immediately the correct treatment. In this article, we report a rare case of MP in a critically ill COVID-19 patient with ARDS, with the main aim to create awareness for MP among the medical team working.
Chen X, Tian J, Li G, et al. Initiation of a new infection control system for the COVID-19 outbreak. Lancet Infect Dis 2020;20:397-8.
DOI: https://doi.org/10.1016/S1473-3099(20)30110-9
Sohrabi C, Alsafi Z, O'Neill N, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020;76:71-6.
DOI: https://doi.org/10.1016/j.ijsu.2020.02.034
Hassan SA, Sheikh FN, Jamal S, et al. Coronavirus (COVID-19): A review of clinical features, diagnosis, and treatment. Cureus 2020;12:e7355.
DOI: https://doi.org/10.7759/cureus.7355
Sadacharan C. Microanatomy of the lateral femoral cutaneous nerve in relation to inguinal ligament and its clinical importance. Medical Express 2016;3:M160106.
DOI: https://doi.org/10.5935/MedicalExpress.2016.01.06
Cansü E, Yücel İ, Özturan K. Meralgia paresthetica: Case report in a policeman. J Med Duzce 2010;12:67-9.
Grossman MG, Ducey SA, Nadler SS, et al. Meralgia paresthetica: diagnosis and treatment. J Am Academy Orth Surg 2001;9:336-44.
DOI: https://doi.org/10.5435/00124635-200109000-00007
Kaiser R. Meralgia paresthetica. Rozhledy v chirurgii: mesicnik Ceskoslovenske chirurgicke spolecnosti 2018;97:286-290.
Chen CK, Phui VE, Saman MA. Alcohol neurolysis of lateral femoral cutaneous nerve for recurrent meralgia paresthetica. Agri 2012;24:42-4.
DOI: https://doi.org/10.5505/agri.2012.47450
Langford B, Mauck WD. Peripheral nerve stimulation: A new treatment for meralgia paresthetica. Pain Med 2021;22:213-6.
DOI: https://doi.org/10.1093/pm/pnaa326
Juhl CS, Ballegaard M, Bestle MH, et al. Meralgia paresthetica after prone positioning ventilation in the intensive care unit. Case Rep Critical Care 2016;2016:7263201.
DOI: https://doi.org/10.1155/2016/7263201
Wongmek A, Shin S, Zhou L. Skin biopsy in assessing meralgia paresthetica. Muscle Nerve 2016;53:641-3.
DOI: https://doi.org/10.1002/mus.25044
Yang SH, Wu CC, Chen PQ. Postoperative meralgia paresthetica after posterior spine surgery: incidence, risk factors, and clinical outcomes. Spine 2005;30:E547-550.
DOI: https://doi.org/10.1097/01.brs.0000178821.14102.9d
Philip CN, Candido KD, Joseph NJ, et al. Successful treatment of meralgia paresthetica with pulsed radiofrequency of the lateral femoral cutaneous nerve. Pain Physician 2009;12:881-5.
DOI: https://doi.org/10.36076/ppj.2009/12/881
Pollard CA, Morran MP, Nestor-Kalinoski AL. The COVID-19 pandemic: a global health crisis. Physiol Genomics 2020;52:549-57.
DOI: https://doi.org/10.1152/physiolgenomics.00089.2020
Hanley B, Lucas SB, Youd E, et al. Autopsy in suspected COVID-19 cases. J Clin Pathol 2020;73:239-42.
DOI: https://doi.org/10.1136/jclinpath-2020-206522
Ellul MA, Benjamin L, Singh B, et al. Neurological associations of COVID-19. Lancet Neurol 2020;19:767-83.
DOI: https://doi.org/10.1016/S1474-4422(20)30221-0
Douglas WW, Rehder K, Beynen FM, et al. Improved oxygenation in patients with acute respiratory failure: The prone position. Am Rev Respir Dis 1977;115:559-66.
Paternoster G, Sartini C, Pennacchio E, et al. Awake pronation with helmet continuous positive airway pressure for COVID-19 acute respiratory distress syndrome patients outside the ICU: A case series. Med Intensiva 2020;S0210-5691(20)30273-4.
Lee JM, Bae W, Lee YJ, et al. The efficacy and safety of prone positional ventilation in acute respiratory distress syndrome: updated study-level meta-analysis of 11 randomized controlled trials. Critical Care Med 2014;42:1252-62.
DOI: https://doi.org/10.1097/CCM.0000000000000122
Bastoni D, Poggiali E, Vercelli A, et al. Prone positioning in patients treated with non-invasive ventilation for COVID-19 pneumonia in an Italian emergency department. Emerg Med J 2020;37:565-6.
DOI: https://doi.org/10.1136/emermed-2020-209744
Richards H, Robins-Browne K, O'Brien T, et al. Clinical benefits of prone positioning in the treatment of non-intubated patients with acute hypoxic respiratory failure: a rapid systematic review. Emerg Med J 2021;38:594-9.
DOI: https://doi.org/10.1136/emermed-2020-210586
Nersesjan V, Amiri M, Lebech AM, et al. Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up. J Neurol 2021;268:3086–104.
DOI: https://doi.org/10.1007/s00415-020-10380-x
Christie F, Quasim T, Cowan R, et al. Meralgia paraesthetica in intensive care unit survivors of COVID-19. Anaesthesia 2021;76:712-3.
DOI: https://doi.org/10.1111/anae.15355
Serrano Barrenechea L, Nordin J, Sörbo A. [Meralgia paresthetica after prolonged prone position at the intensive care unit among COVID-19 patients. A case report]. Lakartidningen 2021;118:20163.
Nouraei SA, Anand B, Spink G, et al. A novel approach to the diagnosis and management of meralgia paresthetica. Neurosurg 2007;60:696-700.
DOI: https://doi.org/10.1227/01.NEU.0000255392.69914.F7
How to Cite
Karaaslan, T., Avarisli, A., Durdu, B., & Daskaya, H. (2022). A case of meralgia paresthetica caused by prone positioning in a COVID-19 patient with acute respiratory distress syndrome. Emergency Care Journal, 18(1). https://doi.org/10.4081/ecj.2022.10310
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
