Comparison of the effects of extubation in the prone and supine position in patients operated for lumbar disc herniation

Background: Extubation of patients in supine position after prone operations may lead to unwanted effects on hemodynamic and respiratory parameters during emergence and recovery period. In this study, we aimed to observe the effects of prone position on emergence and recovery periods after prone surgery. Methods: This prospective observational study was studied with sixty patients extubated either in prone position (30 patients) or in supine position (30 patients) after lumbar spinal surgery. Heart rate, non-invasive arterial blood pressure, peripheral oxygen saturation, TOF(Train of four) values and Bispectral Index values were measured, and recorded in all patients during operation, at the time anaesthetic agent was discontinued, before and after extubation. Aldrete recovery score, were recorded together with the severity of cough during emergence and recovery. Sore throat VAS score was recorded at the 1st and 6th hours after extubation. Incidents such as nausea, vomiting, respiratory failure, uncontrolled airway, and decreased saturation were also recorded. Results: The number and severity of cough(p<0.05) and Sore throat VAS(p<0.001) were lower in the prone group. Post-extubation 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 emergence and recovery period compared with the supine group (p>0.05).Conclusions: Extubation in the prone position after lumbar spinal surgery provides a more comfortable emergence and recovery periods by less altering the respiratory status with better recovery profile. Keywords: Spinal surgery-Prone extubation-Anesthesia recover