RT Book, Section
A1 Gottumukkala, Vijaya
A2 Longnecker, David E.
A2 Brown, David L.
A2 Newman, Mark F.
A2 Zapol, Warren M.
SR Print(0)
ID 56629274
T1 Chapter 27. Positioning of Patients for Operation
T2 Anesthesiology, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-178513-6
LK accessanesthesiology.mhmedical.com/content.aspx?aid=56629274
RD 2024/04/20
AB Proper  positioning  of  the  patient  during  the  operative  period  is  important  for  optimal  surgical  exposure  and  outcome.Understanding  the  pathophysiologic  changes  and  special  considerations  associated  with  each  position  helps  reduce  positioning-related  morbidity.Improper  positioning  during  surgery  can  lead  to  spinal  cord  ischemia,  postoperative  peripheral  neuropathies,  muscular  sprain  injuries,  ischemic  injury  to  skin  and  muscles,  and  visual  loss.Perioperative  peripheral  nerve  injuries  are  the  second  most  common  cause  of  professional  liability  among  anesthesiologists.New  and  advanced  surgical  procedures  (robotic)  may  involve  unconventional  and  extreme  positioning  techniques,  necessitating  better  understanding  of  the  physiologic  consequences  of  positioning  and  enhanced  vigilance  to  prevent  injury  to  the  patient.Male  gender,  extremes  of  body  habitus,  and  prolonged  hospitalization  are  risk  factors  for  postoperative  peripheral  neuropathies.A  thorough  assessment  of  risk  factors  for  complications  related  to  positioning  should  be  an  integral  part  of  the  preoperative  evaluation.As  part  of  the  informed  consent,  risks  and  benefits  associated  with  positioning  should  be  discussed  with  the  patient.Description  of  intraoperative  positioning  techniques  and  measures  taken  to  prevent  injury  should  be  documented  in  the  anesthetic  record.Familiarity  and  understanding  of  the  American  Society  of  Anesthesiologists  (ASA)  Task  Force  on  Prevention  of  Perioperative  Peripheral  Neuropathies  may  help  with  minimizing  the  problems  associated  with  positioning  during  the  perioperative  period.Special  attention  needs  to  be  paid  to  minimize  the  potential  for  visual  injuries  in  high-risk  patients  during  the  perioperative  period.A  report  by  the  ASA  Task  Force  on  perioperative  blindness  is  an  excellent  source  of  current  information  and  consensus  expert  opinion  on  this  devastating  problem.