الفهرس 
CARDIOVASCULAR CONSIDERATIONSOnly 14 pages are availabe for public view
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Abstract
The aim of optimal positioning for surgery is to provide
the best surgical access while minimizing potential risk to the
patient. Each position carries some degree of risk and this is
magnified in the anesthetized patient who cannot make others
aware of compromised positions.
Commonly adopted positions include supine, lithotomy,
lateral, seated and prone. Many of these are modified with the
addition of a vertical tilt (Trendelenburg or reverse
Trendelenburg). This article addresses the general complications
associated with positioning as well as the position-specific
physiological changes and complications.
Positions seemed optimal for surgery; often result in
undesirable physiologic changes, such as hypotension from
impaired venous return to the heart or oxygen desaturation owing
to ventilation-perfusion mismatching. In addition, peripheral
nerve injuries during surgery remain a significant source of
perioperative morbidity.
Proper positioning requires the cooperation of
Anesthesiologists, surgeons, and nurses to ensure patient wellbeing
and safety while providing surgical exposure. Patients
should be placed in a position that they would tolerate when
awake. Padded surfaces and natural joint position are optimal.
Extreme positions of the joints should be avoided whenever
possible.