What Is Surgical Positioning?

What Is Surgical Positioning?

Positioning of a patient refers to a body position or arrangement of the body part that is maintained by or imposed on a patient in the course of a particular diagnosis or treatment. The main purpose of surgical positioning is to maximize anatomic exposure for the surgical procedure to allow the procedure to be performed as simply as possible and to achieve the best possible results. Anesthesia providers share a critical responsibility for the proper positioning of patients in the operating room. Proper positioning requires the cooperation of anesthesia providers, surgeons, and nurses to ensure patient wellbeing and safety while permitting surgical exposure.

Positions deemed optimal for surgery (that would not be tolerated if awake) often result in undesirable physiologic changes such as hypotension, hypoxia, and peripheral nerve injuries. The incidence of injury increases if the patient experiences hypotension and hypothermia. Care must be taken to check the patient for areas at risk for injury. All pressure points should be padded and secure. Peripheral joint extremities are padded, and the normal lumbar spine curvature is supported. The head should remain in a midline position without substantial extension or flexion. No pressure should be placed on the eyes. The duration of more extreme positions, when necessary, should be limited as much as possible. Use of safety straps and prevention of a patient falling off the operating room table to the floor are fundamental. The need for tilting of the operating room table during surgery should be anticipated before draping, and the patient secured accordingly.