An unusual position of patient on operating table.A

 A 64 year old lady had a fracture of left numerous head and the head of the scapula about a month back
See picture II. She had initial breathing problem with small resp reserve. After a week of breathing exercise and incentive spirometry her condition improved

 The patient was induces with Midazolam, Nalbuphine 20mg and Propofol 100mg and Vecuronium 6mg. It was a case of difficult intubation which was completed in third attempt with use of bougie and stilate. After the tube was secured the patient was handed over.

 Now the surgical requirement was that the left shoulder should hand outside the table beyond the left upper corner of the table. To support the head which was outside the table needed to be supported. A horse shoe shaped head support which is usually used in Neuro surgery was brought in. Unfortunately the head support could only be placed in the middle and the shoulder still needed to be outer border of the table.

So another small attachment was procured that was fixed to the left of the middle. A ring was placed the patients head was put on it. But again secured with an elstoplast all around the head and the support. (See picture). This was a very unusual position that needed attention and took almost more than 30 mins to fix.. The surgery lasted for 5&1/2 hours .

Note:

This is a very unusual position and likely to be dislodged if and when the surgeon manipulates te shoulder . Anaesthetist should be careful and alert the surgeon when ever needed