The Effect of Surgical Position on Pain Occurrence Outside the Surgical Area

Background: Postoperative pain outside the surgical area is often overlooked but can affect patient recovery. Intraoperative positioning causes uneven pressure distribution, tissue compression, and nerve strain that trigger pain at non-surgical sites. This study evaluated the effect of surgical position on postoperative pain characteristics and consistency of findings across subpopulations. Objective: To compare pain occurrence, location count, and intensity across three surgical positions in the first 24 hours postoperatively. Methods: Observational cross-sectional study of 340 adult elective surgery patients (duration ≥2 hours): supine n=187, lateral n=119, prone n=34. Pain assessment at 6, 12, 18, 24 hours using Numerical Rating Scale (NRS) and 20-location anatomical map. Analyses included Kruskal-Wallis, Mann-Whitney U with Bonferroni correction (α=0.017), and stratified multiple regression by anesthesia type: general anesthesia with intubation (n=191), general anesthesia with LMA (n=74), regional anesthesia SAB (n=75). Dependent variable was pain location count at 24 hours; independent variables were surgical position, BMI, operation duration. Results: Pain location count differed significantly between positions at all timepoints (H=256.949-257.875, df=2, p