Abstract
The posterior fossa (also known as the infra-tentorial fossa) is a defined space within the cranium that has relatively poor compliance and contains several vital structures that are densely compacted. Its contents include the cerebellum, midbrain, pons and the medulla where the lower cranial nerve nuclei and regulatory centers responsible for the control of cardiovascular and respiratory function are located. Surgery and pathology within the posterior fossa are therefore, associated with the potential for severe disruption to normal physiology. Challenges for anesthesiologists include the requirement for appropriate and meticulous positioning, the prompt recognition and management of perioperative complications as well as the use of anesthetic techniques that facilitate cardiovascular stability and early post-operative neurological assessment.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Greenberg MS. Handbook of neurosurgery. 7th ed. New York: Thieme Publishers; 2010.
Jagannathan S, Krovvidi H. Anaesthetic considerations for posterior fossa surgery. Contin Educ Anaesth Crit Care Pain. 2014;14(5):202–6.
Jessop ZM, Kane AD, Menon DK. The role of early tracheostomy in patients with posterior fossa haemorrhage in neurocritical care. J Intensive Care Soc. 2012;13(4):293–6.
Veenith T, Absalom AR. Anaesthetic management of posterior fossa surgery. In: Matta BF, Menon DK, Smith M, editors. Core topics in neuroanaesthesia and neurointensive care. Cambridge: Cambridge University Press; 2011. p. 237–45.
Mirski MA, Lele AV, Fitzsimmons L, Toung TJK. Diagnosis and treatment of vascular air embolism. Anesthesiology. 2007;106:164–77.
Porter JM, Pidgeon C, Cunningham AJ. The sitting position in neurosurgery: a critical appraisal. Br J Anaesth. 1999;82:117–28.
Fathi A-R, Eshtehardi P, Meier B. Patent foramen ovale and neurosurgery in sitting position: a systematic review. Br J Anaesth. 2009;102(5):588–96.
Edgcombe H, Carter K, Yarrow S. Anaesthesia in the prone position. Br J Anaesth. 2008;100(2):165–83.
Pajewski TN, Arlet V, Phillips LH. Current approach on spinal cord monitoring: the point of view of the neurologist, the anesthesiologist and the spine surgeon. Eur Spine J. 2007;16(Suppl 2):115–29.
Depth of anaesthesia monitors—Bispectral Index (BIS), E-Entropy and Narcotrend-Compact M. National Institute of Clinical Excellence. 2012. https://www.nice.org.uk/guidance/DG6. Accessed 3 March 2018.
Webber S, Andrzejowski J, Francis G. Gas embolism in anaesthesia. Br J Anaesth. 2002;2(2):53–7.
Gore PA, Maan H, Chang S, Pitt AM, Spetzler RF, Nakaji P. Normobaric oxygen therapy strategies in the treatment of postcraniotomy pneumocephalus. J Neurosurg. 2008;108(5):926–9.
Morad A, Winters B, Stevens R, White E, et al. The efficacy of intravenous patient-controlled analgesia after intracranial surgery of the posterior fossa: a prospective, randomized controlled trial. Anesth Analg. 2012;114(2):416–23.
Furay C, Howell T. Paediatric neuroanaesthesia. Contin Educ Anaesth Crit Care Pain. 2010;10:172–6.
Harrison EA, Mackersie A, McEwan A, Facer E. The sitting position for neurosurgery in children: a review of 16 years’ experience. Br J Anaesth. 2002;88(1):12–17.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Singh, N. (2018). Anesthetic Management for Posterior Fossa Surgery. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_57
Download citation
DOI: https://doi.org/10.1007/978-3-319-74766-8_57
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-74765-1
Online ISBN: 978-3-319-74766-8
eBook Packages: MedicineMedicine (R0)