INTRAOPERATIVE EFFECTS OF THE PRONE POSIT ION - ANESTHETIC CONSIDERATIONS

The prone position is commonly used for surgery of the spine and the p osterior fossa, and is well tolerated by the majority of patients. As long as the abdomen is not compressed, the physiologic impact of this position on cardiorespiratory function is minor, in some cases even le ss than with the supine position. However extremes of position, partic ularly of the head and neck, are poorly tolerated and may lead to a va riety of severe neurological complications. In addition, several speci fic forms of pre-existing pathology may predispose the prone patient t o major cardiorespiratory complications. In this paper we have systema tically reviewed the English and French literature from 1991 to 1997 u sing Medline Search of peer reviewed journals for the search terms ''p rone position'' and ''prone position and venous air embolism''. The 33 0 collected references were reviewed for quality. In combination with review of current standard textbooks these references form the basis f or the current report. (C) 1998 Elsevier, Paris.