title: Elevation of a patient's trunk and legs does not influence length of stay in the post-anesthesia care unit.
abstract: BACKGROUND
  Patient recovery time after anesthesia depends on problem-oriented monitoring and individual assessment.
  
  
  OBJECTIVE
  To investigate the influence of patient positioning on post-anesthesia recovery time.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Post-anesthesia care unit, Hospital das Clínicas, São Paulo.
  
  
  METHODS
  Data were obtained from patients recovering from anesthesia in a supine horizontal position or with their trunk and legs elevated at 30 degrees. Data were recorded every 30 minutes. The start time was considered to be the admission to the unit, and the final measurement was taken with the patient reached an Aldrete-Kroulik index of 10. The length of time until discharge was recorded.
  
  
  RESULTS
  442 patients recovering after general (n = 274) or regional anesthesia (n = 168) were assigned to be kept in a supine position or with their trunk and legs elevated. There was no difference in the medians for non-parametric results, between supine position (75 min, n = 229) and trunk and legs elevated (70 min, n = 213); p = 0.729. Patients recovered faster from regional anesthesia with trunk and legs elevated (70 min) than in the supine position (84.5 min), although not significantly (p = 0.097). There was no difference between patients recovering from general anesthesia, no matter the positioning (70 min; p = 0.493).
  
  
  CONCLUSIONS
  Elevated legs may supposedly improve venous return and cardiac output since spinal anesthesia blocks sympathetic system and considering leg-raising has been shown to improve cardiac output from hipovolemia. Our findings did not support this hypothesis. Some limitations included a retrospective collection of data that did not allow randomization for recovery position and the unregistered duration of the exposure to the anesthetic drugs.
  
  
  CONCLUSIONS
  There was no difference in anesthesia recovery time in relation to positioning patients supinely or with trunk and legs elevated.
authors.affiliation: Post-Anesthesia Care Unit, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Otávio
authors.initials: O
authors.lastname: Omati
authors.forename: Fábio Ely Martins
authors.initials: FE
authors.lastname: Benseñor
authors.forename: Joaquim Edson
authors.initials: JE
authors.lastname: Vieira
mesh_terms: D000328:Adult; D017677:Age Distribution; D000762:Anesthesia Recovery Period; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016683:Supine Position / Q000502:physiology