Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases.
نویسندگان
چکیده
AIM The sitting position is routinely used in many centers, although its use remains controversial and appears to be diminishing because of the risk of venous air embolism (VAE). MATERIAL AND METHODS This is a retrospective analysis of 601 adult and 91 pediatric cases underwent neurosurgery from January 1995 through December 2010 in the sitting position. The incidence of VAE and other complications related to the sitting position has been determined. VAE was defined as a sudden and sustained decrease of end-tidal carbon dioxide (ETCO2) ≥0.7 kPa. RESULTS The incidence of VAE in children and adults were found to be 26.3% (n=24) and 20.4% (n=123) consecutively but the difference was not significant. The incidence of positioning induced hypotension was more in adults (37.6%) compared to children (18.6%, p=0.00001). The presence of COPD (p=0.04) and ASA status (p=0.03) showed a correlation with 'hypotension with positioning'. There was no peroperative mortality. CONCLUSION The study provides a significant body of data on neuroanesthesia for the sitting position and our results suggest that if the sitting position is a neurosurgical necessity it can be used with vigilant follow up throughout the procedure to detect any occurrence of VAE by ETCO2 monitoring if you do not have the chance to use more sensitive tools.
منابع مشابه
A Survey of 423 Cases of Skull Fracture in " Loghman-E-Hakin " Medical Center. Shaheed Beheshti University of Medical Sciences & Health Services.
This retrospective study is performed on 423 cases of skull farcture who refered to "Loghman-eHakim" hospital during a 493 days period (October 1994-March 1995): The fracture types were linear in 85% Depressed in 7%, Basilar in 8% of cases. 71.2% of all cases were male and 28.8% were femal. 72.6% of fracture occured in pediatric age group "Less than 15 years old" and 27.4% in adult group. The ...
متن کاملComparison of success rates in performing lumbar puncture and reduction of its anxiety and pain between standard sitting and lateral decubitus positions in 1 to 5-year-old children
Background: Lumbar puncture (LP) is a worth procedure in diagnosis of oncological diseases and intrathecal administration of antineoplastic drugs. The effort should be to minimize pain of LP in children with cancers. This clinical trial was done to compare success rates in performing LP and reducing anxiety and pain of LP in sitting and lateral decubitus positions in 1 to 5-year-old children. ...
متن کاملPediatric spine injuries after trauma: a review of 43 cases
Abstract Objective: To evaluate and review our experience with pediatric spinal injuries and factors affecting outcome, the authors conducted a retrospective clinical study of 43 cases (32 boys, 11 girls) of pediatric spine injuries treated during four years (January 1999 to December 2003). Methods: Forty-three children with spinal injuries were studied retrospectively over four y...
متن کاملAnatomical Variations of Brachial Plexus in Adult Cadavers; A Descriptive Study
Background: Variations of the brachial plexus are common and a better awareness of the variations is of crucial importance to achieve successful results in its surgical procedures. The aim of the present study was to evaluate the anatomical variations of the brachial plexus in adult cadavers. Methods: Bilateral upper limbs of 32 fresh cadavers (21 males and 11 females) consecutively referre...
متن کاملDiagnostic Value of Mallampati Test in Supine and Sitting Positions with and without Phonation in Anesthesia
Background and purpose: Airway assessment is very important in anesthesia. The aim of this study was to determine the diagnostic value of Mallampati test indicators in supine and sitting positions with and without phonation in anesthesia candidate patients. Materials and methods: This cross-sectional descriptive study (diagnostic approach) was done in 200 adult patients ≥16 years, undergoing s...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Turkish neurosurgery
دوره 21 4 شماره
صفحات -
تاریخ انتشار 2011