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Lateral Position

What Is It, Uses, and More

Authors:Lily Guo,Emily Miao, PharmD,Stacy Johnson, LMSW

Editors:Alyssa Haag,Kelsey LaFayette, DNP, ARNP, FNP-C

Illustrator:Jessica Reynolds, MS


What is the lateral position?

The lateral position, known as the lateral decubitus position or the lateral recumbent position, refers to one of the ways an individual can lie on a table in the operating room during a procedure. In lateral positioning, the person lies on their left or right side with the operative side up. The individual’s legs are flexed with pillows or foam padding between them. Supports, including rolled-up blankets, gel rolls, or bean bags, are placed on both the anterior and posterior of their body to prevent the individual from rolling onto their front or back during surgery. Another pad is placed under the chest wall to reduce the excess pressure on the arm and axilla and prevent neurovascular structures from being damaged. 

Patient lying on side with knees flexed.

What is the lateral position used for?

The lateral position is commonly used for thoracic surgeries, surgeries involving retroperitoneal structures (e.g., kidneys, adrenal glands, pancreas, nerve roots, lymph nodes, abdominal aorta, and inferior vena cava), and surgeries of the hip. It is likewise used for other non-surgical procedures, such as lumbar punctures, which use a syringe to withdraw and examine the cerebrospinal fluid (CSF) to provide diagnostic information in the case of a suspected central nervous system (CNS) infection or suspected subarachnoid hemorrhage. It is commonly used to position children who need a lumbar puncture since proper restraint can be maintained (i.e., a health care professional can place one arm around the posterior aspect of the child's neck and the other arm under the child's knees, securing them for the lumbar puncture). 

It is likewise used for other non-surgical procedures, such as lumbar punctures, which use a syringe to withdraw and examine the cerebrospinal fluid (CSF) to provide diagnostic information in the case of a suspected central nervous system (CNS) infection or suspected subarachnoid hemorrhage. It is likewise used for other non-surgical procedures, such as lumbar punctures, which use a syringe to withdraw and examine the cerebrospinal fluid (CSF) to provide diagnostic information in the case of a suspected central nervous system (CNS) infection or suspected subarachnoid hemorrhage. 

The lateral position is additionally used for peripheral nerve blocks of the lower extremity, typically performed during operative anesthesia or postoperative analgesia for lower extremity surgeries. One example of a peripheral nerve block is the lumbar plexus block, also known as the psoas compartment block. During the placement of a lumbar plexus block, the individual is placed in the lateral decubitus position, with the operative side up. The operative leg is flexed at the hip and knee, identifying the iliac crests and the spinous processes of the lumbar spine. An ultrasound machine can be used to assist in finding the transverse process and psoas muscle to guide needle insertion. The needle is inserted into the posterior third of the psoas major muscle, beyond which the lumbar plexus lies. Anesthesia is then injected to prevent pain during procedures or provide pain relief.

While the lateral position is useful for several surgeries and procedures, it can be associated with injuries to the shoulder joint ligaments and damage to the brachial plexus. Since the individual’s neck is flexed laterally for the duration of the procedure, they can experience injury and damage to the neck. Additionally, blood may pool in the lower extremity closest to the table, reducing venous return, which can cause a drop in blood pressure and decreased stroke volume. Additionally, the individual may experience hypoxia as the lung closest to the table is physically compressed and may be ventilating less efficiently. 

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Related links

Anatomy clinical correlates: Vertebral canal
Brachial plexus

Resources for research and reference

Fastle, R. K., Bothner, J. (n.d.). Lumbar puncture: Indications, contraindications, technique, and complications in children. UptoDate. Retrieved June 27, 2022, from https://www-uptodate-com.rosalindfranklin.idm.oclc.org/contents/lumbar-puncture-indications-contraindications-technique-and-complications-in-children?search=lateral+position+&source=search_result&selectedTitle=6~150&usage_type=default&display_rank=6#H15 

Jeng, C. L., & Rosenblatt , M. A. (n.d.). Lower extremity nerve blocks: Techniques. UpToDate. Retrieved June 27, 2022, from https://www-uptodate-com.rosalindfranklin.idm.oclc.org/contents/lower-extremity-nerve-blocks-techniques?search=lateral+position+&source=search_result&selectedTitle=9~150&usage_type=default&display_rank=9 

Pryor, A., Bates, A. T. (n.d.). Abdominal access techniques used in laparoscopic surgery. UptoDate . Retrieved June 27, 2022, from https://www-uptodate-com.rosalindfranklin.idm.oclc.org/contents/abdominal-access-techniques-used-in-laparoscopic-surgery?search=lateral+position+&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3 

Welch, M. B. (n.d.). Patient positioning for surgery and anesthesia in adults. UptoDate . Retrieved June 27, 2022, from https://www-uptodate-com.rosalindfranklin.idm.oclc.org/contents/patient-positioning-for-surgery-and-anesthesia-in-adults?search=lateral+position+&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2645459452