Sitting position in neurosurgical procedure: king hussein medical center experience 2003-2004

ABSTRACT

The incidence of air embolism is still high with low mortality and morbidity if preventive measures and proper monitoring were taken. This will make management quick and effective. Forty patients underwent neurosurgical procedure in the sitting position for posterior fossa tumors, pineal tumor, foramen magnum decompression and cervical disc between January 2003 and January 2004. Gender and age distribution, venous air embolism, hypotension, postoperative ventilation and other complications were studied. Venous air embolism was found in 10% of patients who had a drop in their end tidal carbon dioxide by 5mmHg Hypotension with a 20% drop of the baseline blood pressure de/eloped in 5% of patients in the absence of hypovolemia. Patients who developed combined venous air embolism and severe hypotension were resuscitated by intravenous fluid and ventilated electively. Sitting position is safe if done with preventive measures and strict monitoring. Prompt management of complication is essential to reduce morbidity