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.
