Perioperative Complications Related to Patient Positioning in Neurosurgical Procedures: A Prospective Observational Study
Position-Related Complications in Neurosurgery
DOI:
https://doi.org/10.71350/ajaic.25Keywords:
Neurosurgery, Patient positioning, Perioperative complications, Anesthesia, Patient safetyAbstract
Background: Although patient positioning in neurosurgical procedures is essential for optimal surgical exposure, it may adversely affect venous drainage, airway management, hemodynamic stability, and peripheral neurovascular structures. The aim of this study was to prospectively evaluate perioperative complications related to surgical positioning and head fixation methods in neurosurgical procedures.
Material and Methods: This prospective, single-center observational study included 61 adult patients scheduled for neurosurgical procedures under general anesthesia. Patients were divided into two groups according to the occurrence of position-related perioperative complications. The primary outcome was the development of position-related perioperative complications, while secondary outcomes included hemodynamic changes and perioperative time variables.
Results: During the perioperative period, a total of 12 position-related complications were identified in 10 patients (16.4%). The most frequently observed complications were bilateral orbital edema and diffuse facial edema. Anesthesia duration was significantly longer in the complication group compared with the uncomplicated group (p = 0.021). No significant differences were observed between the groups with respect to surgical duration, intraoperative fluid administration, or blood product transfusion. There was no statistically significant association between surgical position and the development of complications. Mean arterial pressure and heart rate values measured at different perioperative time points were comparable between the groups (all p>0.05). Position-related complications were most commonly observed in the prone position and predominantly involved the facial and upper airway soft tissues.
Conclusion: Position-related perioperative complications occur at a non-negligible frequency in neurosurgical procedures. Appropriate patient positioning, standardized padding, and meticulous intraoperative management are of critical importance in ensuring patient safety.
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