July 2011
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Introduction Although monitoring vital signs is an important part of the anesthesiologist's responsibility perioperatively, it is far from being the sole task. As advocates of patient safety, anesthesiologists are also involved in setting and monitoring the patient's position during surgery. Because nerve injuries resulting from patient malpositioning may lead to serious morbidity, the American Society of Anesthesiologists (ASA) published a practice advisory for the prevention of peripheral neuropathies associated with positioning in the perioperative period. Furthermore, a task force was created aiming at practice improvement based on limited available scientific data. In this chapter, we discuss the most common patient positions during surgery; explore how patient positioning may lead to adverse outcomes, particularly nerve injuries; and review the current guidelines for preventing nerve injuries due to malpositioning.