The liver is located under the right diaphragm and cannot be adequately visualized under normal circumstances. Therefore, hepatectomy is usually performed with general anesthesia or general anesthesia plus epidural anesthesia, and the flat or lateral position is often used during surgery.
The semi-recumbent position after surgery has a positive effect on patient respiration, circulation, inflammation management, and incisional healing, enhancing overall comfort and safety.
Benefits improved respiratory and circulatory status
The respiratory center remains depressed, ventilation is reduced, and tidal volume is limited by the dual effects of residual general anesthetic and postoperative analgesic medications for 6 hours postoperatively. At the same time, postoperative abdominal distension, pain, and restricted diaphragmatic motion further aggravate the ventilatory insufficiency.
At this time, the semi-recumbent position increases pulmonary compliance, lung volume, and diaphragmatic mobility, which can increase tidal volume by 10%-15%, while increasing the amount of cardiac return and improving systemic circulation.
Beneficial for infection prevention and incisional healing
The postoperative period of 6 to 12 hours is the peak of blood and fluid leakage from the liver section and abdominal cavity trauma. Adopting a semi-recumbent position allows the fluid to concentrate in the drainage tube area and drain out of the body in a timely manner, reducing peritoneal absorption and preventing subdiaphragmatic infection.
In addition, the semi-recumbent position helps to reduce the tension of the abdominal incision, relieves pain, and facilitates the healing of the incision.
Increases patient comfort
Due to the prolonged intraoperative position immobilization and the continuation of the same position postoperatively, patients may experience skin pressure sores, prolonged stress soreness in some muscle groups, and generalized fatigue.
The change to a semi-recumbent position satisfies the patient’s requirement for timely position change and relief of discomfort and increases comfort.