title: Effect of head position on postoperative chemosis after prone spinal surgery.
abstract: Conjunctival swelling is a common finding in patients positioned prone. The purpose of this study was to evaluate the effect of head position on postoperative chemosis after prone spinal surgery. On the basis of the head position, 108 patients scheduled for prone lumbar surgery were randomly allocated to 1 of 2 groups: head neutral group (n=54) versus head down (HD) group (n=54). Head position was defined as neutral when the imaginary line from the occipital protuberance to the top of C7 spine process is parallel to the operating table. HD position was maintained by adjusting the height of the prone headrest 5 cm lower than neutral position. Chemosis was evaluated after surgery. The severity of chemosis, which was graded as none, mild, moderate, and severe, showed statistically significant difference between the head neutral group [24 (44%), 25 (46%), 3 (6%), 2 (4%), respectively] and HD group [10 (19%), 23 (43%), 17 (31%), 4 (7%), respectively, P<0.01]. Positive fluid balance and duration of surgery were risk factors for the development of postoperative chemosis. This result suggested that neutral head position, smaller fluid administration, and shorter duration of surgery were useful in decreasing the development of postoperative chemosis after prone spinal surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang hospital, Sungnam, South Korea.
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Jeon
authors.forename: Yun Ok
authors.initials: YO
authors.lastname: Park
authors.forename: Jung
authors.initials: J
authors.lastname: won Hwang
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Lim
authors.forename: Yong Seok
authors.initials: YS
authors.lastname: Oh
authors.forename: Hee Pyoung
authors.initials: HP
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D003229:Conjunctival Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D004487:Edema / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D006257:Head / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D011187:Posture; D016684:Prone Position; D011446:Prospective Studies; D018401:Sample Size; D013131:Spine / Q000601:surgery*