Intraoperative Patient Positioning and Neurological Injuries

Abstract

Thoracic cases usually involve repositioning the patient after induction of anesthesia. Vigilance is required to avoid major displacement of airway devices, lines, and monitors during and after position changes. Obtaining central venous access after changing to the lateral position is extremely difficult. If a central line may be needed, it should be placed at induction. Prevention of peripheral nerve injuries in the lateral position requires a survey of the patient from the head and sides of the operating table prior to draping. Post-thoracotomy paraplegia is primarily a surgical complication.