Comparison of Effects of Extubation in Prone and Supine Positions in Patients Operated for Lumbar Disc Herniation.

Abstract

To observe the effects of prone position extubation on respiratory side effects and hemodynamic parameters in patients who underwent lumbar spinal surgery. This prospective observational study included 60 patients extubated in either the prone (n=30) or supine (n=30) positions. Heart rate, noninvasive arterial blood pressure, peripheral oxygen saturation, train of four values, and bispectral index values were measured and recorded in all patients during operation and at the time of anesthetic agent discontinuation, before and after extubation. The Aldrete recovery score was recorded together with the severity of cough during emergence and recovery. Sore throat visual analog scale (VAS) score was recorded at the first and sixth hours after extubation. Incidents such as nausea, vomiting, respiratory failure, uncontrolled airway, and decreased saturation were also recorded. The number and severity of cough (p < 0.05) and sore throat VAS (p < 0.001) were lower in the prone group. Postextubation breath holding was more frequent in the supine group (p < 0.001). Aldrete recovery scores were higher in the prone group (p < 0.05). Heart rate and mean arterial pressure values were not significantly different in the prone group during the emergence and recovery period as compared with the supine group (p > 0.05). Extubation in the prone position after lumbar spinal surgery provides more comfortable emergence and recovery periods with less alteration of respiratory status and a better recovery profile.