A Randomized Controlled Trial of Patient Positioning During Endoscopic Retrograde Cholangiopancreatography (ERCP) Procedures: A Comparison Between Semi-Prone- and Prone-Positioned Patients.

The trial was conducted in one hospital endoscopy unit, so results may not transfer to other settings. Two patients initially included in the prone group required lateral positioning and were excluded and replaced, so the trial did not represent people who could not tolerate prone positioning. Airway access, oral access and pharynx passage were rated by clinicians on a six-point scale, so these outcomes depend on assessor judgement. Pressure and nerve injury checks were done in recovery only, and the authors note such injuries may be visible or experienced later. The paper reports one prone patient developed a pressure injury under the left eye from the oxygen tube, which healed by the second day post-procedure. Transient hypoxia and hypotension were excluded from adverse events, so mild cardiorespiratory events were not counted. Patient satisfaction with the semi-prone and swimmers positions was not measured. The methods label group A and group B inconsistently, which makes the group descriptions harder to check.

Do not conclude that semi-prone positioning prevents brachial plexus injury or pressure injury. The trial's main outcomes were cannulation attempts and time, not injury prevention, and injury checks were limited to recovery.