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The goal of this clinical trial is to learn which positioning strategy works better to prevent postoperative hypoxemia in surgical patients: semirecumbent positioning or lateral positioning. It will also learn about the safety and effectiveness of these two positioning approaches. The main questions it aims to answer are:
Does semirecumbent positioning reduce the incidence of postoperative hypoxemia more effectively than lateral positioning? Does lateral positioning reduce the incidence of postoperative hypoxemia more effectively than semirecumbent positioning? What are the differences in patient comfort and recovery outcomes between these two positioning strategies? Researchers will compare semirecumbent positioning directly to lateral positioning to see which approach is more effective in preventing postoperative hypoxemia.
Participants will:
Be randomly assigned to either semirecumbent positioning or lateral positioning after surgery Have their oxygen levels and breathing monitored regularly during the postoperative period Receive standard post-surgical care with their assigned positioning strategy Be assessed for comfort levels and any positioning-related complications Have their recovery progress tracked throughout their hospital stay.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Semirecumbent positioning | Experimental | Patients in the Semirecumbent positioning were placed in the bed and the head of the bed was raised by 30 °, allowing flexibility based on patient comfort and surgical requirements. |
|
| Lateral positioning | Experimental | Patients allocated to lateral positioning were placed at 90° on a horizontal bed, supported with a pillow to maintain neutral alignment of the spine and avoid hyperextension or forward flexion of the neck. No preference was specified for left or right lateral decubitus positioning, allowing flexibility based on patient comfort and surgical requirements. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lateral positioning | Behavioral | Patients allocated to lateral positioning were placed at 90° on a horizontal bed, supported with a pillow to maintain neutral alignment of the spine and avoid hyperextension or forward flexion of the neck. No preference was specified for left or right lateral decubitus positioning, allowing flexibility based on patient comfort and surgical requirements. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of hypoxaemia | Defined as any occurrence of oxygen saturation (SpO2) ≤90% for at least five seconds during the initial 10 minute period after positioning. | Within 24 hours after the surgery was completed |
| Measure | Description | Time Frame |
|---|---|---|
| Rrequency of airway rescue interventions | Increased oxygen flow, jaw thrust manoeuvre, mask ventilation | Within 24 hours after the surgery was completed |
| incidence of severe hypoxaemia | oxyhemoglobin saturation ≤85% |
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Inclusion Criteria:
Exclusion Criteria:
Inclusion criteria:
- Patients aged 18 years and above, and 80 years and below, who received general anesthesia and intubation;
Exclusion criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yuhu Ma, Master | Contact | 18419379740 | mayh20@lzu.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Yatao Liu, Doctor | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38941098 | Result | Wang X, Guo K, Sun J, Yang Y, Wu Y, Tang X, Xu Y, Chen Q, Zeng S, Wang L, Liu S. Semirecumbent Positioning During Anesthesia Recovery and Postoperative Hypoxemia: A Randomized Clinical Trial. JAMA Netw Open. 2024 Jun 3;7(6):e2416797. doi: 10.1001/jamanetworkopen.2024.16797. | |
| 40829895 | Result | Ye H, Chu LH, Xie GH, Hua YJ, Lou Y, Wang QH, Xu ZX, Tang MY, Wang BD, Hu HY, Ying J, Yu T, Wang HY, Wang Y, Ye ZJ, Bao XF, Wang MC, Chen LY, Wang XX, Zhang XB, Huang CS, Wang J, Lu YP, Luo FQ, Zhou W, Wang CG, Cheng H, Liu WJ, Luo J, Wu YQ, Li RR, Wang D, Hou LQ, Shi L, Zhang J, Wang K, Pi X, Zhou R, Yang QQ, Wan PL, Li H, Wu SJ, Song SW, Cui P, Shu L, Islam N, Fang XM. Effect of lateral versus supine positioning on hypoxaemia in sedated adults: multicentre randomised controlled trial. BMJ. 2025 Aug 19;390:e084539. doi: 10.1136/bmj-2025-084539. |
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| ID | Term |
|---|---|
| D000860 | Hypoxia |
| ID | Term |
|---|---|
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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|
| Semirecumbent positioning | Behavioral | Patients in the semi-recumbent position were placed in the bed and the head of the bed was raised by 30 °, allowing flexibility based on patient comfort and surgical requirements. |
|
| Within 24 hours after the surgery was completed |
| Lowest oxygen saturation | Defined as the oxygenation nadir during 10 minutes of continuous measurement. | Within 24 hours after the surgery was completed |
| Duration of stay in the post-anaesthesia care | Duration of stay in the post-anaesthesia care | Perioperative/Periprocedural |
| wound pain | VAS scale was used to measure pain intensity. The VAS uses a 10 cm line with endpoint descriptors such as 'no pain' marked at the left end of the line and 'worst pain imaginable' marked at the right end. A VAS score between 4-7 represents "mild pain", a score between 4-7 represents "moderate pain" and a score between 8-10 represents "severe pain". | Perioperative/Periprocedural |
| Adverse events | hypotension, arrhythmia, and some other adverse events. | Perioperative/Periprocedural |