There is an ongoing debate about the sitting position SP in neurosurgical patients. These complications and methods of prevention diagnosis and treatment are discussed in detail and the literature concerning the sitting position in neurosurgery is reviewed.
Cunningham Departments of Anaesthesia and Neurosurgery Royal College of Surgeons in IrelandBeaumont Hospital Dublin 9 Ireland To whom correspondence should be addressed at.
Sitting position neurosurgery. 1Department of Neurosurgery University of Erlangen-Nuremberg Schwabachanlage 6 91054 Erlangen Germany oliverganslandtuk-erlangende. Sitting Position 193. The sitting position in neurosurgery.
Venous air embolism VAE occurred in 274 of 226 patients operated on in the sitting position and in none of the 59 patients operated on in a nonsitting position. A retrospective analysis of 488 cases. The potential for serious complications after venous air embolism and successful malpractice liability claims are the principle reasons for the dramatic decline in the use of the sitting position in neurosurgical practice.
The best monitoring system for the detection of VAE is still controversial. The sitting position in neurosurgery. The paediatric neurosurgeons at our institution routinely use the sitting position for posterior fossa and pineal surgery and a retrospective audit of the incidence of VAE from 1982 to 1998 has been performed.
A single institution experience of 600 cases Acta Neurochir Wien 155 2013 pp. T raditionally the sitting position has been the preferred position to. Assessment of the relative risk-benefit based on the individual patients physical status and surgical implications for the particular intracranial pathology is of paramount importance.
Although sitting position offers distinct advantages to the surgeon the extent of removal of tumor neurological outcomes and facial nerve preservation have not been shown to be very different as compared to the lateral position in a recent study. PubMed CrossRef Google Scholar. It remains a French and international controversy about the use of the sitting position in neurosurgery.
The sitting position in neurosurgery. To 97 of the institutions the recommendations of the Neuroanesthesia Study Group of the DGAI were well known 19 modified their anesthetic approach due to. The aim of this study was to evaluate the frequency of sitting position use perioperative monitoring and procedures for air embolism detection and treatment.
79 Journal of Neuroanaesthesiology and Critical CareVol. A prospective study with transoesophageal echocardiography. Department of Anaesthesia Beaumont Hospital Dublin 9.
Surgical Approach for Procedures of the Spine 195. Surgically access the posterior cranial fossa or posterior cervical spine. Papadopoulos G Kuhly P Brock M Rudolph KH Link J Eyrich K.
The sitting position was preferred for posterior fossa surgery by 45 of the neurosurgeons for craniospinal operations by 35 and for cervical spine surgery by the dorsal approach by 39. The 30-day operative mortality was 25. 13 The sitting position is known to cause hypotension and decrease in cardiac function presenting a challenge to the neuroanesthesiologist in guaranteeing sufficient cerebral blood pressure and oxygen delivery.
Neurosurgical procedures in sitting position need advanced cardiovascular monitoring. The benefit of the sitting position for surgery of the posterior fossa and cervical spine is still a matter of controversy. Department of Anaesthesia Beaumont Hospital Dublin 9 Ireland.
British Journal of Anaesthesia 82 1. However several caveats must be emphasized. Complications Associated With Sitting Position 194.
Limited use of the sitting position should remain in the neurosurgeons armamentarium. A critical appraisal J. Cunningham Departments of Anaesthesia and Neurosurgery Royal College of Surgeons in IrelandBeaumont Hospital Dublin 9 Ireland To whom correspondence should be addressed at.
We conclude that the sitting position during neurosurgery should be avoided in patients with preoperative evidence of a right-to-left shunt at contrast echocardiography to reduce. Venous and paradoxical air embolism in the sitting position. A critical appraisal J.
It is the most commonly used position in neurosurgery. 27 Instrumented cervical surgeries have also been done in the sitting position. 7 No22020 is more than 17 mLkgmin20 Precordial Doppler is highly sensitive as.
Contraindications to Sitting Position 194. The sitting position for neurosurgery. It does not require any special equipment for positioning and is.
The benefits of a sitting position for neurosurgery involving the posterior fossa remain controversial. The main concern is the risk of venous air embolism VAE. The SP provides a number of advantages as well as severe complications such as commonly concerning venous air embolism VAE.
Patient Positioning for Spinal Procedures 195. The main concern is the risk of venous air embolus VAE and its sequelae. Neurosurgery in the sitting position also decreases the incidence of cranial nerve damage.
Although there have been several studies substantiating the relative safety c. 11728 1999 REVIEW ARTICLE The sitting position in neurosurgery. Indications complications and results.
Use of the sitting position for neurosurgery is controversial. Sitting Position in Neurosurgery Goraksha et al. 1887 - 1893 CrossRef View Record in Scopus Google Scholar.