BACKGROUND: Use of the sitting position for neurosurgery is controversial. The main concern is the risk of venous air embolus (VAE) and its sequelae. METHODS: 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. RESULTS: Venous air embolism, defined as a fall in end-tidal carbon dioxide pressure >0.4 kPa, was detected in 38 of 407 operations (9.3%). A fall in systolic arterial pressure >10% accompanied the VAE in nine out of 43 episodes (20.9%); this represents 2% of all operations. All VAE episodes responded promptly to treatment and there was no perioperative morbidity or mortality directly attributed to it. CONCLUSIONS: This is the largest study of the incidence of VAE in children undergoing neurosurgery. Our results suggest that the sitting position can be used safely for neurosurgery in children.
BACKGROUND: Use of the sitting position for neurosurgery is controversial. The main concern is the risk of venous air embolus (VAE) and its sequelae. METHODS: 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. RESULTS:Venous air embolism, defined as a fall in end-tidal carbon dioxide pressure >0.4 kPa, was detected in 38 of 407 operations (9.3%). A fall in systolic arterial pressure >10% accompanied the VAE in nine out of 43 episodes (20.9%); this represents 2% of all operations. All VAE episodes responded promptly to treatment and there was no perioperative morbidity or mortality directly attributed to it. CONCLUSIONS: This is the largest study of the incidence of VAE in children undergoing neurosurgery. Our results suggest that the sitting position can be used safely for neurosurgery in children.
Authors: Juan F Martínez-Lage; María-José Almagro; Virginia Izura; Cristina Serrano; Antonio M Ruiz-Espejo; Isabel Sánchez-Del-Rincón Journal: Childs Nerv Syst Date: 2009-07-10 Impact factor: 1.475
Authors: Daniel S Leon-Ariza; Rubby J Romero Chaparro; Lisa Rosen; Juan S Leon-Ariza; Fidias E Leon-Sarmiento; Juan Villalonga; Alfredo Quinones-Hinojosa; Alvaro Campero Journal: Cureus Date: 2021-11-15