The Lounging Position for Posterior Fossa Surgery: Anesthesiological Considerations Regarding Air Embolism
Overview
Authors
Affiliations
The sitting position for operations in the posterior fossa remains controversial in both adults and children, primarily because of the risk of air embolism. The reports on the incidence of this complication are varied. We retrospectively reviewed the data on 704 patients (age range 1-82 years) operated on in a lounging position for varied posterior fossa pathology from January 1984 up to December 1989. As diagnostic monitoring, we uniformly employed a Doppler ultrasound device, an atrial catheter, and capnometry. In 37 adults (5.5%) and 9 children (9/34) air embolism was diagnosed, without either morbidity or mortality. A lounging position, together with adequate infusion therapy and ventilation with PEEP, considerably reduces the risk of air embolism.
The safety and utility of the semi-sitting position for clipping of posterior circulation aneurysms.
Al-Afif S, Lang J, Abdulbaki A, Palmaers T, Scheinichen D, Abu-Fares O Acta Neurochir (Wien). 2024; 166(1):341.
PMID: 39160268 PMC: 11333526. DOI: 10.1007/s00701-024-06229-1.
Machetanz K, Leuze F, Mounts K, Trakolis L, Gugel I, Grimm F Acta Neurochir (Wien). 2020; 162(11):2629-2636.
PMID: 32712719 PMC: 7550361. DOI: 10.1007/s00701-020-04504-5.
Microsurgical resection of vestibular schwannomas: complication avoidance.
Rahimpour S, Friedman A, Fukushima T, Zomorodi A J Neurooncol. 2016; 130(2):367-375.
PMID: 27650193 DOI: 10.1007/s11060-016-2260-4.
The history of ependymoma management.
Shim K, Kim D, Choi J Childs Nerv Syst. 2009; 25(10):1167-83.
PMID: 19458954 DOI: 10.1007/s00381-009-0900-0.
Surgical management of medulloblastoma.
Sutton L, Phillips P, Molloy P J Neurooncol. 1996; 29(1):9-21.
PMID: 8817412 DOI: 10.1007/BF00165514.