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Canadian Journal of Anesthesia/Journal canadien d'anesthésie
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 6/2016

01-06-2016 | Continuing Professional Development

An update on the prone position: Continuing Professional Development

Authors: Jason Chui, MBChB, Rosemary Ann Craen, MBBS

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 6/2016

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Abstract

Purpose

The purpose of this Continuing Professional Development module is to provide information needed to prepare for and clinically manage a patient in the prone position.

Principal findings

Prone positioning is required for surgical procedures that involve the posterior aspect of a patient. We searched MEDLINE® and EMBASE™ from January 2000 to January 2015 for literature related to the prone position and retrieved only original articles in English. We reviewed the advantages and disadvantages of various equipment used in prone positioning, the physiological changes associated with prone positioning, and the complications that can occur. We also reviewed strategies for the safe conduct and management of position-related complications.

Conclusion

Increased age, elevated body mass index, the presence of comorbidities, and long duration of surgery appear to be the most important risk factors for complications associated with prone positioning. We recommend a structured team approach and careful selection of equipment tailored to the patient and surgery. The systematic use of checklists is recommended to guide operating room teams and to reduce prone position-related complications. Anesthesiologists should be prepared to manage major intraoperative emergencies (e.g., accidental extubation) and anticipate postoperative complications (e.g., airway edema and visual loss).
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Metadata
Title
An update on the prone position: Continuing Professional Development
Authors
Jason Chui, MBChB
Rosemary Ann Craen, MBBS
Publication date
01-06-2016
Publisher
Springer US
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 6/2016
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-016-0634-x

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