A Comparative Study between Supine and Semi-Fowler's Position during Extubation and Post Anesthesia Care Unit Following Abdominal Surgeries: a One-Year Hospital-Based Randomized Controlled Trial

Background: The objective of this study was to compare the outcomes of patients placed in the supine position versus the semi‐Fowler's position during extubation and in the post‐anesthesia care unit (PACU) following abdominal surgeries. Methods: This one‐year, randomized controlled trial was conducted at a tertiary care hospital in Uttar Pradesh. A total of 200 patients undergoing abdominal surgeries under general anesthesia were randomly assigned to either the supine position group or the semi‐Fowler's position group. In the supine group, patients were kept in a flat supine position during extubation and in the PACU. In the semi‐Fowler's group, patients were placed in a semi‐Fowler's position with the head of the bed elevated at an angle of 30‐45 degrees. The primary outcomes measured were the incidence of postoperative complications, including respiratory distress, hypoxemia, and aspiration. Secondary outcomes included hemodynamic stability, pain scores, time to extubation, and length of stay in the PACU. Results: The incidence of postoperative complications, including respiratory distress, hypoxemia, and aspiration, was significantly lower in the semi‐Fowler's position group compared to the supine position group (p < 0.05). Patients in the semi‐Fowler's position group exhibited better hemodynamic stability, lower pain scores, and shorter time to extubation compared to the supine position group (p < 0.05). However, there was no significant difference in the length of stay in the PACU between the two groups (p > 0.05). Conclusion: Placement of patients in the semi‐Fowler's position during extubation and in the PACU following abdominal surgeries reduces the incidence of postoperative complications, improves hemodynamic stability, and leads to faster recovery compared to the supine position. Therefore, adopting the semi‐Fowler's position as a routine practice in the postoperative period may enhance patient outcomes and recovery following abdominal surgeries.