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Results for “Supine Position”

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PubMedDate not supplied

Comparison of astigmatic axis in the seated and supine positions.

BACKGROUND: Refractive error is assessed in the seated position while keratorefractive procedures are performed in the supine position. Since position-induced ocular torsion could yield suboptimal results from improper axis alignment, this study was undertaken to ascertain whether ocular cyclotorsion occurs when a subject moves from a seated to supine position. METHODS: Fifty eyes of 29 subjects with refractive cylinder greater than 0.50 diopters were enrolled. Refraction was done with a phoropter and the correction was placed in a trial frame using plus cylinder. Astigmatic axis was determined in the seated and supine positions for 32 eyes by utilizing the "rocking the cylinder" technique and for 32 eyes using the Jackson cross cylinder. Both techniques were used for 14 eyes. RESULTS: No statistically-significant difference for cylinder axis measured in the seated versus supine position was observed using the rocking the cylinder (4.3 degrees standard deviation [SD], 3.5 degrees, range 0 degrees to 13 degrees, p = NS) or the Jackson cross cylinder methods (2.3 degrees, SD, 1.9 degrees, range 0 degrees to 7 degrees, p = NS). Approximately 25% of eyes had a change in axis of 7 degrees to 16 degrees. CONCLUSIONS: These data suggest that the cylinder axis does not change significantly or predictably when most subjects move from the seated to supine position. The Jackson cross cylinder method seems more accurate and reproducible than the rocking the cylinder technique in determination of astigmatic axis under these circumstances.

Adult↗

PubMed2006

Changes of corneal aberrations in sitting and supine positions.

PURPOSE: To examine the effect of posture change on corneal aberrations and corneal curvature. DESIGN: Observational case series. METHODS: The Keratron topographer, improved to measure patients in the supine position, was used to measure the corneal aberrations and the curvature in nine healthy volunteers. The first measurement took place with the subject in the sitting position and the others in the supine position, immediately after assuming the supine position and then 30 minutes later. RESULTS: The total higher-order and spherical-like aberrations were significantly increased from the sitting position to the supine position (P=.011, and P=.044, Scheffé test). CONCLUSIONS: These results suggest that the increase in the higher-order aberration from the sitting to the supine position acts to limit the improvements in visual performance after customized refractive surgery based on wavefront measurement.

Adult↗

PubMed2002

Effect of delayed supine positioning after induction of spinal anaesthesia for caesarean section.

BACKGROUND: The study tested the hypothesis that the incidence of hypotension during spinal anaesthesia for caesarean section is less in parturients who remain in the sitting position for 3 min compared with parturients who are placed in the modified supine position immediately after induction of spinal anesthesia. METHODS: Spinal anaesthesia was induced with the woman in the sitting position using 2.8 ml hyperbaric bupivacaine 0.5% at the L(3-4) or L(2-3) interspace. Ninety-eight patients scheduled for elective caesarean section under spinal anaesthesia were randomised to assume the supine position on an operating table tilted 10 degrees to the left (modified supine position) immediately after spinal injection (group 0, n=52) or to remain in the sitting position for 3 min before they also assumed the modified supine position (group 3, n=46). Isotonic saline 2-300 ml was given intravenously over 15 min before spinal injection followed by 15 ml/kg over 15-20 min after induction of spinal anaesthesia. If the systolic blood pressure decreased to less than 70% of baseline or to less than 100 mmHg or if there was any complaint of nausea, ephedrine was given in 5 mg boluses intravenously every 2 min. RESULTS: The blood pressure decreased significantly in both groups following spinal injection (P<0.001). Blood pressure variations over time differed significantly between the two groups (P<0.05). However, the incidence of maternal hypotension before delivery was similar in the two groups. The difference was caused by the time to the blood pressure nadir being significantly shorter in group 0 compared with group 3 (9.1+/-4.5 min vs. 11.7+/-3.7 min, P<0.01). Similar numbers of patients received rescue with ephedrine before delivery: 35 (67%) in group 0 vs. 26 (57%) in group 3 (NS). The mean total dose of ephedrine before delivery was 10.9 mg in group 0 vs. 9.2 mg in group 3 (NS). There were no differences in neonatal outcome between the two groups. CONCLUSION: At elective caesarean section, a 3-min delay before supine positioning does not influence the incidence of maternal hypotension after induction of spinal anaesthesia in the sitting position with 2.8 ml of bupivacaine 0.5% with 8% dextrose.

Adult↗

PubMed2004

Kinesthetic estimation of the main orientations from the upright and supine positions.

This work investigated the accuracy of the perception of the main orientations (i.e., vertical and horizontal orientations) with the kinesthetic modality--a modality not previously used in this field of research. To further dissociate the influence of the postural and physical verticals, two body positions were explored (supine and upright). Twenty-two blindfolded participants were asked to set, as accurately as possible, a rod to both physical orientations while assuming one of the two body positions. The horizontal was perceived more accurately than the vertical orientation in the upright position but not in the supine position. Essentially, there were no differences in the supine position because the adjustments to the physical vertical were much more accurate than they were in the upright position. The lower accuracy in the estimation of the vertical orientation observed in the upright position might be linked to the dynamics associated with the maintenance of posture.

Adult↗

PubMed2004

Supine position compared to other positions during the second stage of labor: a meta-analytic review.

The routine use of the supine position during the second stage of labor can be considered to be an intervention in the natural course of labor. This study aimed to establish whether the continuation of this intervention is justified. Nine randomized controlled trials and one cohort study were included. A meta-analysis indicated a higher rate of instrumental deliveries and episiotomies in the supine position. A lower estimated blood loss and lower rate of postpartum hemorrhage were found in the supine position, however it is not clear whether this is a real or only an observed difference. Heterogenous, non-pooled data showed that women experienced more severe pain in the supine position and had a preference for other birthing positions. Many methodological problems were identified in the studies and the appropriateness of a randomized controlled trial to study this subject is called into question. A cohort study is recommended as a more appropriate methodology, supplemented by a qualitative method to study women's experiences. Objective laboratory measurements are advised to examine the difference in blood loss. In conclusion, the results do not justify the continuation of the routine use of the supine position during the second stage of labor.

Adult↗

PubMed1988

Rising from a supine position to erect stance. Description of adult movement and a developmental hypothesis.

Standing up from a supine position is important for physical independence. This study was designed to describe movements within specific body regions used to stand up from a supine position. Another purpose was to identify motor developmental sequences for the upper extremities, lower extremities, and axial region for this rising task. Thirty-two young adults were videotaped while rising from a supine position 10 times. Descriptive categories were formed to portray movements of the upper extremities, lower extremities, and axial region. Subjects varied greatly in the movement patterns they used to rise. Only 25% of the subjects demonstrated a similar combination of movements during rising. That combination involved symmetrical use of the limbs and trunk while flexing forward from a supine position, moving through sitting to squatting, then standing. An ordering of categories was found for each body region that was proposed as a developmental sequence of movement patterns for this task. The variability of subjects' movements while rising provides clinicians with numerous movement combinations that might be used when teaching patients to stand from a supine position.

Adult↗

PubMed1994

The supine position for transsphenoidal surgery.

The supine position has been routinely used for transphenoidal microsurgery in our department since 1973. We had 404 patients, 387 of whom had pituitary micro-or macroadenomas. It is always satisfactory, allowing a very good control of intraoperative arterial pressure and prevention of air embolism. It is also comfortable for both surgeons.

Adenoma↗

PubMed1994

Development of posture in prone and supine positions during the prenatal period in low risk preterm infants.

The development of posture in the prone and supine positions was studied longitudinally in 10 low risk preterm infants between 31 and 39 weeks' postmenstrual age whose subsequent neurological development at 18 months old was normal. The infants were observed from one week after birth until the expected date of delivery. All postures were analysed according to the procedures described by Prechtl et al. There were large intraindividual and interindividual differences in posture in terms of the duration and incidence of the two positions. There was no age specific preferred posture found in either position. The posture duration in the prone position was longer than that in the supine position, but overall flexed and abducted posture were observed more often in the former. Turning of the head to the right side was also observed more often in the prone than in the supine position.

Female↗

PubMed1983

Pre- and postoperative lung function in sitting and supine position related to postoperative chest X-ray abnormalities and arterial hypoxaemia.

Spirometry in both sitting and supine position was performed before and 3-5 days after elective upper abdominal surgery in 53 men, aged 41-72 years. The results were related to postoperative respiratory complications as defined by chest radiography and to measurements of the arterial oxygen tension. Preoperative total lung capacity (TLC), functional residual capacity (FRC) and wash-out volume (WOV) were lower in both positions among patients who were to develop major chest X-ray abnormalities than among patients with normal chest radiographs postoperatively. All patients who developed major chest X-ray abnormalities had a negative value for FRC - closing capacity (CC) in the supine position preoperatively, indicating 'airway closure' during tidal breathing. Preoperative WOV and lung clearance index (LCI) were higher in both sitting and supine positions in patients who developed postoperative hypoxaemia than in patients who did not. The postoperative decrease in TLC, FRC and WOV in the sitting position was greater among patients with major X-ray abnormalities and/or arterial hypoxemia postoperatively than among patients without these complications. According to our results, conventional spirometry in the supine position is not superior to conventional spirometry in the sitting position as part of pre- or post-operative assessment of patients. On the other hand, both preoperative 'airway closure' and arterial oxygen tension, measured in the supine position, showed a correlation with postoperative chest X-ray abnormalities.

Adult↗

PubMed2006

Can a finite set of knee extension in supine position be used for a knee functional examination?

The kinematic magnetic resonance imaging technique has been developed to provide a functional examination of the knee. Technical limitations require this examination to be performed in supine position, and the knee motion is represented by an assembly of static positions at different knee angles. However, the main knee function is to support the body weight and perform continuous motion, e.g. parallel squat. Our study quantified the knee kinematics of 20 healthy subjects in different motion conditions (finite and continuous) and in different mechanical conditions (continuous unloaded and continuous loaded). We evaluated the angular and localisation difference of a finite helical axis of the knee motion for parallel squat, continuous knee extension in supine position and the finite set of knee extension in supine position. We found large inter-individual dispersion. The majority of subjects had equivalent knee kinematics between continuous knee extension and the finite set of knee extension in supine position, but not between continuous knee extension in supine position and the parallel squat. Therefore, results from a functional examination of a finite set of knee extensions in supine position do not represent the knee motion in a parallel squat. Our results suggest that functional examination of the knee from magnetic resonance imaging do not necessarily reflect the physiological kinematics of the knee. Further investigation should focus on a new magnetic resonance imaging acquisition protocol that allows image acquisition during weight bearing or includes a special device which reproduces the loaded condition.

Adult↗

PubMed1983

Functional ophthalmodynamometry. Comparison between brachial and ophthalmic blood pressure in sitting and supine position.

Ophthalmodynamometry was done by 96 normotensive volunteers and 62 hypertensive patients in sitting and supine position. A high correlation between the brachial and ophthalmic blood pressure was found in both groups, and in both positions. The brachial blood pressure of normotensive subjects did not show any difference in both positions. Although the systolic brachial blood pressure did not show significant changes in hypertension, the diastolic--and the calculated mean brachial blood pressure has been slightly but significantly decreased in the supine position. In both groups, normotension and hypertension, the ophthalmic blood pressure was found to be dependent from the level of the systemic blood pressure and the position of patient. It is significantly higher in the supine position than in the sitting position. The higher the systemic blood pressure in the sitting position, the less was the increase of the ophthalmic blood pressure in the supine position.

Blood Pressure↗

PubMed2004

Diaphragmatic motion in the sitting and supine positions: Healthy subject study using a vertically open magnetic resonance system.

PURPOSE: To determine the postural difference of diaphragmatic motion between the sitting and supine positions. MATERIALS AND METHODS: A total of 10 healthy men were examined using a vertically open 0.5-T magnetic resonance (MR) system. A total of 40 sequential MR images were obtained in both the sitting and supine positions during two to five respiratory cycles. The diaphragmatic excursions (DEs) were measured on three diaphragmatic points of six sagittal planes for both positions. The differences in DEs between the anterior and posterior parts of the diaphragm were also determined. RESULTS: DEs in the supine position were significantly greater than those in the sitting position at 15 of the 18 points. In five of the six sagittal planes, the difference of DE between posterior and anterior points was significantly larger in the supine position than in the sitting position. CONCLUSION: Diaphragmatic movement in the supine position is greater than that in the sitting position, especially in the posterior part of the diaphragm.

Adult↗

PubMed2002

Severe intraoperative air embolism during convexity meningioma surgery in the supine position. Case report.

BACKGROUND: Acute venous air embolism (AE) is a well-known intraoperative complication of neurosurgical procedures, especially during surgical procedures performed in the sitting position, but it is a rare complication in the supine position. A case of a patient who developed an AE during a supratentorial craniotomy in the supine position is presented and the literature is reviewed. CASE DESCRIPTION: A 45-year-old man had a large left frontal convexity meningioma. He was operated upon and, during craniotomy in the supine position, suffered a massive episode of air embolism with severe respiratory and hemodynamic changes. The AE episode occurred while we were cutting the bone for the craniotomy before turning the bone flap. Because the patient was bleeding profusely, the bone flap was quickly removed to achieve hemostasis. Aspiration of irrigant into the cut bone surfaces through several venous diploic channels in the bone edges was observed. The procedure was terminated when hemostasis was achieved. The meningioma was successfully removed in a second operation. CONCLUSION: We think that our case should serve to warn the neurosurgical community about the risk of AE in supratentorial procedures in the supine or semisitting positions when preoperative radiological imaging studies show the presence of important venous channels in relation to the site of the tumor.

Craniotomy↗

PubMed2004

Colpocystoproctography in the upright and supine positions correlated with dynamic MRI of the pelvic floor.

PURPOSE: To test whether there are statistically significant differences between measurement results on colpocystoproctography in the upright and the supine positions, and to correlate these results with dynamic MRI. PATIENTS AND METHODS: Seven patients with pelvic floor descent had received colpocystoproctography in the upright and supine positions and, additionally, dynamic MRI of the pelvic floor. Bladder neck position, angle of urethral inclination, posterior vesicourethral angle, and vaginal vault position were measured at relaxed pelvic floor and at pelvic strain. Differences between the measurement results of each parameter in the upright and supine position on colpocystoproctography were calculated and correlated with the measurement results from the dynamic MRI. RESULTS: At pelvic strain, bladder neck position, angle of urethral inclination, posterior vesicourethral angle and vaginal vault position measurements showed no statistically significant differences between colpocystoproctography in the upright and supine positions or dynamic MRI. For the bladder neck height at pelvic floor relaxation, significant differences were found between colpocystoproctography in the upright and supine positions, and colpocystoproctography in the upright position versus dynamic MRI. CONCLUSION: At pelvic strain, measurement data from dynamic MRI are not statistically different from data from colpocystoproctography either in supine and upright positions.

Aged↗

PubMed1997

Cardiac axis change between prone and supine positioning may contribute to differences in 99Tc(m)-MIBI myocardial SPET imaging.

The aims of this study were to assess the effect of prone and supine positioning on 99Tc(m)-MIBI myocardial SPET images and the contribution of cardiac axis change. We compared 227 tomograms of patients imaged in the prone position with 227 tomograms of the same patients imaged in the supine position. For each tomographic session, the axis angle of the heart was recorded using an in-house program. The results showed a significant change in the cardiac axis angle of 9 degrees in the transaxial plane (P < 0.001). This change in the cardiac axis correlated with differences in cardiac wall activity (wall activity when the patient was imaged in the prone position minus wall activity when the patient was imaged in the supine position). Our results suggest that factors other than diaphragmatic movement and attenuation could account for the differences in wall activity observed when patients are imaged prone versus supine. Differences in the intensity of photon attenuation in the heart itself, depending on the cardiac axis, could be a contributing factor. Quantitation of the variation in wall activity leads us to suggest that 99Tc(m)-MIBI SPET should be performed in the prone position to allow better visualization of the inferior and the septal walls. The anterior and lateral walls are better studied in the supine position. Images acquired in both the prone and supine positions would allow the best assessment of all walls.

Coronary Disease↗

PubMed2002

Changing nursery practice gets inner-city infants in the supine position for sleep.

OBJECTIVE: To determine whether an educational intervention to change nursery practice would result in more inner-city parents placing their infants in the supine position for sleep. DESIGN: We conducted semistructured interviews at the 2-week health supervision visit with 1 convenience sample of parents before and a different convenience sample of parents after an educational intervention was conducted to change nursery practice in positioning infants for sleep. SETTING: University hospital clinic located in an urban setting. PARTICIPANTS: Parents of 2-week-old infants at their first health supervision visit in an urban, university-affiliated clinic. All parents who were approached agreed to participate. INTERVENTION: Nurses were instructed to place infants exclusively in the supine position in the nursery and to instruct parents to exclusively place infants in the supine sleeping position at home. MAIN OUTCOME MEASURE: The usual sleeping position in which parents reported placing their 2-week old infants. RESULTS: Before the intervention, 41% of parents reported that a clinician had told them to place their infants to sleep in the supine position compared with 81% after the intervention (odds ratio [OR], 6.1; 95% confidence interval [CI], 3.1-12.3). Before the intervention, 37% of parents reported that the nursery staff placed their infants to sleep in the supine position, compared with 88% after the intervention (OR, 12.5; 95% CI, 5.7-27.7). Before the intervention, 42% of parents reported that they usually placed their infants to sleep in the supine position at home compared with 75% after the intervention (OR, 4.2; 95% CI, 2.1-7.9). CONCLUSION: After an educational intervention to change practice in a well-newborn nursery, many more parents reported placing their infants in the supine position for sleep, which suggests that such an intervention may have an impact on the position in which parents place their children to sleep.

Adolescent↗

PubMed1992

[Aggravation of hypoxemia in supine position in myotonic dystrophy].

Myotonic dystrophy (MyD) involves a variety of systems. Respiratory disorders are common, namely elevation of diaphragm, alveolar hypoventilation, aspiration pneumonia and sleep apnea. We evaluated respiratory involvement. The subjects were 11 patients with MyD. Also 6 patients with limb girdle muscular dystrophy (LG) were examined to be compared with MyD. Both groups had the similar activities of daily living. All of them never complained of dyspnea. Arterial blood gas studies were performed in supine position and standing position. A new evidence was found that hypoxemia was aggravated and alveolar-arterial oxygen pressure difference was increased in supine position in MyD. Next, pulmonary function tests were done in supine position and sitting position. Functional residual capacity (FRC) were more reduced in supine position in MyD compared with LG. The value to subtract closing capacity from FRC was negative in supine position in MyD, showing closing phenomenon. We propose the mechanism of the aggravation of hypoxemia may be the following. The reduction of FRC caused by respiratory muscle involvement brings out the closing phenomenon. Abnormal uneven distribution of ventilation-perfusion ratio happens and then hypoxemia is worsened in supine position in MyD.

Adult↗

PubMed2005

Is the supine position as safe and effective as the prone position for endoscopic retrograde cholangiopancreatography? A prospective randomized study.

BACKGROUND AND STUDY AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is usually performed with the patient lying in the prone position, on the assumption that this position is optimal for cannulation of the papilla and for obtaining good-quality radiographic images. The supine position, however, may be more comfortable for the patient and may facilitate airway management, and this study aimed to compare the two positions in terms of procedure outcome, safety, and patient tolerance. PATIENTS AND METHODS: Consecutive patients who were undergoing ERCP were randomized to start the procedure in either the prone position or the supine position. Patients under the age of 18 years, intubated patients, and those who had already undergone endoscopic sphincterotomy were excluded. The difficulty of cannulation was assessed using the Freeman score (1=one to five attempts; 2=six to 15 attempts; 3=more than 15 attempts; 4=failure of cannulation). Total procedure time, patient tolerance, willingness to undergo ERCP in the future, and procedure-related adverse cardiorespiratory events (oxygen desaturation, tachycardia, bradycardia) were also recorded. RESULTS: A total of 34 patients were evaluated (21 men, 13 women; mean age 68, range 20-96), 17 patients in each group. Demographic and clinical features, and the indications for the procedure were similar for the two patient groups. The median Freeman score was significantly lower in the prone group compared with the supine group (1 vs. 3, P=0.0047, rank sum test). Biliary cannulation was achieved in all patients in the prone group, but was not achieved in five patients (29%) in the supine group (P=0.052). In four of these five patients, biliary cannulation was successfully achieved after turning the patient into the prone position. The percentage of patients unwilling to repeat the ERCP procedure in the future was higher in the supine group (29% vs. 6%, P=0.087); the mean tolerance score and mean total procedure time were similar in the two groups. Seven patients in the supine group experienced at least one adverse cardiorespiratory event, compared with only one patient in the prone group (41% vs. 6%, P=0.039). CONCLUSIONS: ERCP performed with the patient in the supine position is technically more demanding for operators used to working with patients in the prone position and carries a greater risk of adverse cardiorespiratory events in nonintubated patients.

Adult↗