SYSTEMATIC REVIEW STUDY OF SAVEETHA UNIVERSAL PRONE FACE REST (SUPFR) VERSUS COMMERCIALLY AVAILABLE FACE REST FOR INCIDENCE OF FACIAL EDEMA AND EASE OF POSITIONING IN PATIENTS UNDERGOING SURGERY UNDER GENERAL ANAESTHESIA IN THE PRONE POSITION

Abstract

Background - Prone positioning is frequently required during spinal, neurosurgical, and orthopedic procedures performed under general anaesthesia. However, prolonged prone positioning may result in facial edema, pressure-related skin injuries, ocular complications, and difficulties in maintaining stable head and airway positioning. The Saveetha Universal Prone Face Rest (SUPFR) has been developed as an indigenous, cost-effective positioning device designed to improve facial pressure distribution and facilitate patient positioning. This study compared the efficacy of SUPFR with a commercially available prone face rest. Objectives: To compare the incidence of facial edema and ease of positioning between the Saveetha Universal Prone Face Rest (SUPFR) and a commercially available prone face rest in patients undergoing surgery under general anaesthesia in the prone position. Materials and Methods: This prospective comparative observational study was conducted in the Department of Anaesthesiology, Sikkim Manipal Institute of Medical Sciences, Gangtok, over a period of 18 months. Sixty adult patients (ASA physical status I–II) undergoing elective surgery under general anaesthesia in the prone position were enrolled and allocated into two groups: Commercial Face Rest (Group A, n=30) and SUPFR (Group B, n=30). Postoperative facial edema, ocular complications, ease of positioning, endotracheal tube stability, pressure marks, postoperative discomfort, and overall complications were compared. Statistical analysis was performed using SPSS version 27.0, with p<0.05 considered statistically significant. Results: Baseline demographic and perioperative characteristics were comparable between the two groups (p>0.05). The incidence of periorbital edema (13.3% vs. 36.7%; p=0.032), conjunctival edema (10.0% vs. 33.3%; p=0.028), conjunctival congestion (16.7% vs. 40.0%; p=0.041), facial edema (10.0% vs. 30.0%; p=0.041), pressure marks (6.7% vs. 33.3%; p=0.009), postoperative discomfort (10.0% vs. 26.7%; p=0.048), and overall complications (16.7% vs. 43.3%; p=0.021) were significantly lower in the SUPFR group. Ease of positioning (73.3% vs. 46.7%; p=0.021) and endotracheal tube stability (93.3% vs. 76.7%; p=0.048) were significantly better with SUPFR. Conclusion: The Saveetha Universal Prone Face Rest significantly reduced facial edema, ocular complications, pressure related injuries, and postoperative discomfort while improving ease of positioning and endotracheal tube stability compared with the commercially available face rest. SUPFR appears to be a safe, effective, and economical alternative for prone positioning during surgery under general anaesthesia, particularly in resource-limited healthcare settings.