Comparison of Surgical and Anesthetic Complications in Neurosurgical Patients Experiencing Venous Air Embolism in the Sitting Position

Anaesthesia for neurosurgery in the sitting position

“…10 Flexing the hips aids venous return, although the knees should also be flexed to minimize stretch on the sciatic nerve. 1 It is important to transduce invasive arterial blood pressure monitoring at the level of the head to ensure adequate cerebral perfusion pressure.…”

Venous air embolism and the sitting position: A case series

“…This figure is similar to those reported for other series. [1][2][3][4][5][6][7][8][9] Venous air embolism was not associated with any other disturbance in physiological variables, including arterial blood pressure and oxygen saturation. Patients suffering venous air embolism in this audit did not have a significantly higher incidence of hypotension during the surgery than those who did not.…”

“…[1][2][3][4][5][6][7][8][9] This wide variation can be explained in part by the different sensitivities and specificities of the various detection techniques. Transoesophageal echocardiography (TOE) has detected venous air embolism in 76% of cases 3 and precordial Doppler in up to 50% of cases, 4 whereas pulmonary artery pressure, central venous pressure, end tidal carbon dioxide partial pressure (ETCO 2 ), end tidal nitrogen, and arterial blood pressure are less sensitive.…”

Sitting position for pineal surgery: Some anaesthetic considerations

“…Hypotension is very frequent in a number of reports [9,10]. Anaesthesia and the pooling of blood in the lower extremities decrease the cardiac index and mean arterial pressure.…”