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Positioning the Patient for Neurosurgical Operations

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Essentials of Neurosurgical Anesthesia & Critical Care

Abstract

Patient positioning for surgery should provide surgical comfort and optimization of surgical exposure, while minimizing positioning-related risks and complications. The most common complications of patient positioning include pressure sores and peripheral nerve damage (brachial, sacral, lumbar plexus, ulnar, radial, sciatic, and common peroneal nerves injuries). Besides length of surgery, preexisting pressure ulcers, extremes of age (neonates, elderly), major comorbidities, thin body habitus, morbid obesity, and/or smoking are risk factors for positioning related pressure ulcers. Most commonly, pressure ulcers occur at the ischium, trochanter, or heel. Other specific complications related to positioning for neurosurgical procedures include cerebral edema and bleeding, visual loss, quadriplegia, venous and paradoxical air embolism, pneumocephalus, and macroglossia.

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Suggested Reading

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben Gurion-University of the Negev, Beer-Sheva, Israel

    Alexander Zlotnik MD

  2. Departments of Anesthesiology and Pain Medicine and Neurological Surgery, Radiology, University of Washington and Harborview Injury Prevention and Research Center, Harborview Medical Center, Seattle, WA, USA

    Monica S. Vavilala MD

  3. Department of Anesthesiology, and Pain Medicine, University of Washington and VA Paget Sound Health Care System, Seattle, WA, USA

    Irene Rozet MD

Authors
  1. Alexander Zlotnik MD
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  2. Monica S. Vavilala MD
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  3. Irene Rozet MD
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Corresponding author

Correspondence to Irene Rozet MD .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, and Perioperative Medicine, Professor, University School of Medicine, Portland, 97214, Oregon, USA

    Ansgar M. Brambrink

  2. Department of Anesthesiology, and Perioperative Medicine, Professor and Chair, University School of Medicine, Portland, 97214, Oregon, USA

    Jeffrey R. Kirsch

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© 2012 Springer Science+Business Media, LLC

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Zlotnik, A., Vavilala, M.S., Rozet, I. (2012). Positioning the Patient for Neurosurgical Operations. In: Brambrink, A., Kirsch, J. (eds) Essentials of Neurosurgical Anesthesia & Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09562-2_15

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  • DOI: https://doi.org/10.1007/978-0-387-09562-2_15

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-09561-5

  • Online ISBN: 978-0-387-09562-2

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