The antigravity suit in neurosurgery

Brodrick, P. M.; Ingram, G

doi:10.1111/j.1365-2044.1988.tb05751.x

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…Compressed air is widely available inside operating theaters: this made easier their use. [ 2 10 22 25 26 ]…”

Section: Discussionmentioning

confidence: 99%

“…Benefits of antigravity trousers in sitting position for neurosurgery were early recognized. [ 2 10 17 22 26 ] However, there is no general consensus about the specific pressure that needs to be used while performing a surgical operation in sitting position. A pressure of 20–40 mmHg has been considered effective and safe by many authors.…”

Section: Discussionmentioning

confidence: 99%

“…A pressure of 20–40 mmHg has been considered effective and safe by many authors. [ 2 10 26 ] A pressure over 40 mmHg for the entire duration of the surgical procedure may be risky, as it may determine a decrease in renal perfusion and urine output, as well as increased respiratory rate and reduced vital capacity. Nonetheless, the risk of ischemic injuries is connected with long periods of antigravity trousers inflation more than with the pressure of inflation itself.…”

Section: Discussionmentioning

confidence: 99%

“…Several advantages may be offered by the use of the sitting position for pineal region surgery such as: lower intracranial pressure, good venous outflow, gravitational retraction, and straight anatomical orientation. [ 2 7 10 17 18 21 22 26 32 ] On the other hand, the sitting position may oblige the surgeon to a nonergonomic tiring position, and may cause potential dreadful complications such as severe venous air embolism (VAE) associated to general hypotension. [ 1 14 25 29 ]…”

Section: Introductionmentioning

confidence: 99%

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Venous air embolisms and sitting position in Helsinki pineal region surgery

Choque-Velasquez¹,

Colasanti²,

Resendiz-Nieves³

et al. 2018

Surg Neurol Int

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Background:Nowadays, the sitting position has lost favor among neurosurgeons partly due to assumptions of increased complications, such as venous air embolisms (VAEs) and hemodynamic disturbances. The aim of our study is to describe the importance of some anesthetic considerations and the utility of antigravity trousers as well, together with a skillful neurosurgery and an imperative proper teamwork, in order to prevent the risk of severe VAE during pineal region surgery. We routinely use them for the variant of the sitting position we developed, the “praying position.”Methods:A retrospective review of 51 pineal lesions operated on in the “praying position” using antigravity trousers was carried out. In the “praying position” the legs of the patient are kept parallel to the floor. Hence, antigravity trousers are used to generate an adequate cardiac preload.Results:VAE associated to persistent hemodinamic changes was nonexistent in our series. The rate of VAE was 35.3%. VAEs were diagnosed mainly by monitoring of the end-tidal CO2 (83.33%). A venous system lesion was the cause in most of the cases. When VAE was suspected, an inmediate reaction based on a good teamwork was imperative. No cervical spine cord injury nor peripheral nerve damage were reported. The average microsurgical time was 48 ± 33 min.Conclusions:The risks of severe VAE during pineal region surgery in the “praying-sitting position” may be effectively prevented by some essential anesthetic considerations and the use of antigravity trousers together with a skillful neurosurgery, and an imperative proper teamwork.

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“…Compressed air is widely available inside operating theaters: this made easier their use. [ 2 10 22 25 26 ]…”

Section: Discussionmentioning

confidence: 99%