Journal ArticleDOI
Anesthesia and surgery in the seated position: analysis of 554 cases.
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TLDR
The seated position is safe in experienced hands if appropriate surgical and anesthetic skills are exercised in patient selection and management, and Caution is advised in patients with atherosclerotic cardiovascular disease, severe hypertension, cervical stenosis, and right to left intracardiac shunts.Abstract:
Because controversy exists regarding continued use of the seated position for neurosurgical procedures, this prospective (1981-1983) and retrospective (1972-1981) analysis of 554 seated patients was done to establish the incidence and severity of venous air embolism (VAE) related to type of surgical procedure and anesthetic technique; to examine the impact of specific monitoring practices on detection, morbidity, and mortality; and to establish the incidence of other complications related to the seated position (hypotension, quadriplegia, and arterial air embolism (AAE)). The overall morbidity and mortality related to the seated position was 1% (2 VAE, 1 AAE, 2 hypotension, 1 myocardial infarction) and 0.9% (1 VAE, 1 AAE, 2 hypotension, 1 quadriplegia), respectively. There has been no mortality since 1975. N2O did not seem to increase the incidence or severity of VAE. The seated position is safe in experienced hands if appropriate surgical and anesthetic skills are exercised in patient selection and management. Caution is advised in patients with atherosclerotic cardiovascular disease, severe hypertension, cervical stenosis, and right to left intracardiac shunts.read more
Citations
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Journal ArticleDOI
Diagnosis and Treatment of Vascular Air Embolism
TL;DR: A comprehensive review of the etiology and diagnosis of vascular air embolism, including approaches to prevention and management based on experimental and clinical data is presented and this compendium of information will permit the healthcare professional to rapidly assess the relative risk of vascularAir Embolism and implement monitoring and treatment strategies appropriate for the planned invasive procedure.
Journal ArticleDOI
Cerebral ischemia during shoulder surgery in the upright position: a case series.
Andrea Pohl,David J. Cullen +1 more
TL;DR: It is argued that the correlation between cardiovascular risk factors and cerebral ischemic complications for shoulder surgery in the beach chair position is poor and the sitting position and the head position create specific physiological conditions that may be conducive to cerebral and spinal cord ischemia during this type of surgery.
Journal ArticleDOI
The sitting position in neurosurgery: a critical appraisal.
TL;DR: With appropriate patient selection and preparation, and using prudent intraoperative monitoring and anaesthetic techniques, selected patients should still benefit from the optimum access to mid-line lesions, improved cerebral venous decompression, lower intracranial pressure and enhanced gravity drainage of blood and CSF associated with the sitting position.
Journal ArticleDOI
Venous and paradoxical air embolism in the sitting position. A prospective study with transoesophageal echocardiography.
TL;DR: It is concluded that a pre-operative search for PFO is mandatory considering its incidence in patients in group 1 and of 10% in group 2, and the risk of PAE.
Journal ArticleDOI
Patent foramen ovale and neurosurgery in sitting position: a systematic review
TL;DR: The conclusions from the systematic review of air embolism complications of neurosurgery in the sitting position and patent foramen ovale (PFO) closure may be limited due to the lack of level A evidence and from using data from observational cohort studies.
References
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Journal ArticleDOI
Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases.
TL;DR: Between 1963 and 1980, one or more posterior-lateral foraminotomies were performed for simple cervical radiculopathy as the sole operative procedure for 736 patients, and most (91.5%) of the patients describe themselves as either "good or excellent" postoperatively.
Book
Anesthetic uptake and action
TL;DR: Find loads of the anesthetic uptake and action book catalogues in this site as the choice of you visiting this page.
Journal ArticleDOI
Abrupt change in head position and cerebral infarction.
TL;DR: The role of anticoagulation in these patients was discussed in this article, where the authors described eight patients who developed infarctions in the vertebral-basilar artery distribution following chiropractic neck manipulation or spontaneous head turning.
Journal ArticleDOI
The sitting position in neurosurgery: a retrospective analysis of 488 cases.
TL;DR: The records of 488 patients who underwent neurosurgical procedures in the sitting position were reviewed with special attention to the development of complications related to this operative position, and methods of prevention, diagnosis, and treatment were discussed in detail.
Journal ArticleDOI
Pathophysiology of Intravenous Air Embolism in Dogs
TL;DR: It is concluded that bolus injection might lead to an air lock in the heart, but slow infusion initially causes a reflex decrease in peripheral resistance, possibly mediated through receptors in the lung.