Page 55 - 2022 Risk Basics - Anesthesiology

SVMIC Risk Basics: Anesthesiology

as a trial before sedation or induction of anesthesia. If the

operating table will be tilted either top to bottom, side to side,
or moved into the sitting position (e.g., during breast

reconstruction) during surgery, the anticipated position should

be practiced before skin preparation and draping, to make sure
supports and straps are secure and that the patient tolerates

the position physiologically.
20

Some examples of intraoperative positioning issues in the
cases reviewed that were alleged to have caused significant

disability to the patient include:

 Brachial plexus injury as a result of inadequate padding

during surgery

 Skin sloughing off after failure to monitor the contact

points of the patient’s face during a lengthy procedure

 Compartment syndrome in the arms as a result of

improper positioning and failure to monitor

Dental Issues

Tooth damage is one of the most common non-threatening
complications in anesthesia, and injuries to the teeth are often

associated with airway care during general anesthesia.

Although anesthesiologists consistently work in the mouth of
patients, they may not have been exposed to a comprehensive

education of teeth, surrounding tissues, and intraoral
prostheses. A thorough preoperative assessment of the

patient’s dental status, including the recognition of vulnerable

20 https://www.uptodate.com/contents/patient-positioning-for-surgery-and-anesthesia-in-adults

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