Abstract
Patient positioning for surgery should provide surgical comfort and optimization of surgical exposure, while minimizing positioning-related risks and complications. The most common complications of patient positioning include pressure sores and peripheral nerve damage (brachial, sacral, lumbar plexus, ulnar, radial, sciatic, and common peroneal nerves injuries). Besides length of surgery, preexisting pressure ulcers, extremes of age (neonates, elderly), major comorbidities, thin body habitus, morbid obesity, and/or smoking are risk factors for positioning related pressure ulcers. Most commonly, pressure ulcers occur at the ischium, trochanter, or heel. Other specific complications related to positioning for neurosurgical procedures include cerebral edema and bleeding, visual loss, quadriplegia, venous and paradoxical air embolism, pneumocephalus, and macroglossia.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
American Society of Anesthesiologists Task Force on the Prevention of Perioperative Peripheral Neuropathies. American Society of Anesthesiologists Task Force on the prevention of perioperative peripheral neuropathies: practice advisory for the prevention of perioperative peripheral neuropathies. Anesthesiology. 2000;92:1168–82.
Black S, Ockert DB, Oliver WC, et al. Outcome following posterior fossa craniectomy in patients in the sitting or horizontal positions. Anesthesiology. 1988;69:49–56.
Miller RD, editor. Miller’s anesthesia. 6th ed. Philadelphia: Churchill Livingston; 2006. p. 2134–42. Chapter 53.
Orliaguet GA, Hanafi M, Meyer PG, et al. Is the sitting or the prone position best for surgery for posterior fossa tumours in children? Paediatr Anaesth. 2001;11:541–7.
St-Arnaud D, Paquin MJ. Safe positioning for neurosurgical patients. AORN J. 2008;87:1156–68. quiz 69–72.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Zlotnik, A., Vavilala, M.S., Rozet, I. (2012). Positioning the Patient for Neurosurgical Operations. In: Brambrink, A., Kirsch, J. (eds) Essentials of Neurosurgical Anesthesia & Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09562-2_15
Download citation
DOI: https://doi.org/10.1007/978-0-387-09562-2_15
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-09561-5
Online ISBN: 978-0-387-09562-2
eBook Packages: MedicineMedicine (R0)