What are the considerations for surgery in the prone position?

What are the considerations for surgery in the prone position?

Induction of anesthesia normally occurs in the supine position using standard agents for hypnosis, analgesia, and muscle relaxation. Following tracheal intubation, patients are placed in the prone position. As with any position change, care must be taken to prevent dislodgment of intravenous lines, an intra-arterial line if placed, and the endotracheal tube. Positioning of the head and extremities requires attention to avoid hyperextension or flexion of the neck. A variety of bolstering devices allow optimal access and posi-tioning while reducing intrathoracic and intra-abdominal pressure (Table 21.1).