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Effect of Position (Semirecumbent Versus Supine) on Postoperative Oxygenation in Markedly Obese Subjects

ROBERT W. VAUGHAN, MD^*, SPOMENKO BAUER, MD, and LESLIE WISE, MD

*Associate Professor of Anesthesiology, Departments of Anesthesiology and Surgery, Washington University School of Medicine, St. Louis, Missouri 63110. Anesthesia Resident, Barnes Hospital, Washington University School of Medicine, St. Louis, Missouri 63110. Associate Professor of Surgery, Departments of Anesthesiology and Surgery, Washington University School of Medicine, St. Louis, Missouri 63110.

Abstract

In 22 markedly obese, otherwise healthy, women studied postoperatively on each of days 1 through 3 after intra-abdominal operation, the effect of position change on arterial oxygenation was assessed. There was a statistically significant decrease in Pao₂, an increase in A-aDo₂ and a simultaneous modest reduction in Paco₂ with the assumption of the supine position on postoperative days 1 and 2, but no positional difference demonstrable in any studied variable by day 3. This report suggests that during the first 48 hours after abdominal surgery in obese patients, assumption and maintenance of the semirecumbent posture is a valuable therapeutic modality to improve arterial oxygenation.

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