Anaesthesia in the prone position

As surgical techniques evolve, the prone position is being used more frequently (e.g. laparoscopic-assisted oesophagectomy) to facilitate surgical access. It is also adopted to improve oxygenation in patients with acute respiratory distress syndrome (ARDS). Nevertheless, the practice of prone positioning remains relatively unfamiliar to the majority of anaesthetists. This article will focus on prone positioning within the operating theatre. It will discuss the effects on physiology, the complications that occur, the practicalities of turning and positioning the patient, and the management of emergencies once prone.