Intraoperative Positioning of Patients Under General Anesthesia and the Risk of Postoperative Pain and Pressure Ulcers

Purpose: Intraoperative positioning is a crucial component of peri-anesthesia care and can lead to postoperative complications. Therefore, this study explored risk factors for postoperative positioning pain and pressure ulcers that were associated with supine positioning in patients undergoing general anesthesia. Design: In this prospective cross sectional exploratory study, 86 ASA I-II, normal BMI patients undergoing elective surgery in the supine position from February to May 2009 were included. Seven different risk factors were examined to detect possible associations between intraoperative positioning and the development of postoperative positioning pain or pressure ulcers. Findings: Only one variable was found to be a significant risk factor for postoperative positioning pain, preoperative pain (P = .017) with an odds ratio of 13.1 (95% CI 1.4-23.9). There were no associations found between positioning pain or pressure ulcers and gender, age, duration of surgery, surface of the operation room bed, and number of monitoring devices. Four patients suffered from pain in their heels; of these, two had bilateral Grade I pressure ulcers. Five patients suffered from arm pain and three patients from neck and back pain. Conclusion: In conclusion, the risk for positioning pain seems to be greater in patients suffering from preoperative pain. Routine documentation and follow-up of a patient's preoperative pain, intraoperative positioning and overall postoperative pain experience are emphasized.