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Positioning the Patient for Neurosurgical Operations

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Essentials of Neurosurgical Anesthesia & Critical Care

Abstract

Patient positioning for neurosurgical operations should allow optimal surgical exposure while ensuring patient safety and comfort. Neurosurgical operations require a variety of patient positions to safely access all aspects of the brain and spinal cord. The most common complications associated with patient positioning are pressure ulcers and peripheral nerve injuries. Other rare, but serious, complications related to positioning for neurosurgical procedures include cerebral edema and bleeding, visual loss, quadriplegia, venous and paradoxical air embolism, pneumocephalus, and macroglossia. Positioning for neurosurgical procedures can also impact cardiovascular and respiratory systems, challenging the neuroanesthesiologist.

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Suggested Reading

  • American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies. Practice advisory for the prevention of perioperative peripheral neuropathies: an updated report by the American Society of Anesthesiologists Task Force on prevention of perioperative peripheral neuropathies. Anesthesiology. 2011;114(4):741–54.

    Article  Google Scholar 

  • Anastasian ZH, Ramnath B, Komotar RJ, Bruce JN, Sisti MB, Gallo EJ, Emerson RG, Heyer EJ. Evoked potential monitoring identifies possible neurological injury during positioning for craniotomy. Anesth Analg. 2009;109(3):817–21.

    Article  Google Scholar 

  • Cassorla J, Lee JW. Chapter 41: patient positioning and associated risks. In: Miller RD, editor. Miller’s anesthesia. 8th ed. Philadelphia: Elsevier/Saunders; 2015. p. 1240–65.

    Google Scholar 

  • Dilmen OK, Akcil EF, Tureci E, Tunali Y, Bahar M, Tanriverdi T, Aydin S, Yentur E. Neurosurgery in the sitting position: retrospective analysis of 692 adult and pediatric cases. Turk Neurosurg. 2011;21(4):634–40.

    PubMed  Google Scholar 

  • Drummond JC, Patel PM, Lemkuil BP. Chapter 70: anesthesia for neurosurgery. In: Miller RD, editor. Miller’s anesthesia. 8th ed. Philadelphia: Elsevier/Saunders; 2015. p. 2158–99.

    Google Scholar 

  • Fathi AR, Eshtehardi P, Meier B. Patent foramen ovale and neurosurgery in sitting position: a systematic review. Br J Anaesth. 2009;102(5):588–96.

    Article  Google Scholar 

  • Glenny RW. Determinants of regional ventilation and blood flow in the lung. Intensive Care Med. 2009;35(11):1833–42.

    Article  Google Scholar 

  • Gracia I, Fabregas N. Craniotomy in sitting position: anesthesiology management. Curr Opin Anaesthesiol. 2014;27(5):474–83.

    Article  CAS  Google Scholar 

  • Kitaba A, Martin DP, Gopalakrishnan S, Tobias JD. Perioperative visual loss after nonocular surgery. J Anesth. 2013;27(6):919–26.

    Article  Google Scholar 

  • Li A, Swinney C, Veeravagu A, Bhatti I, Ratliff J. Postoperative visual loss following lumbar spine surgery: a review of risk factors by diagnosis. World Neurosurg. 2015;84(6):2010–21.

    Article  Google Scholar 

  • Orliaguet GA, Hanafi M, Meyer PG, et al. Is the sitting or the prone position best for surgery for posterior fossa tumours in children? Paediatr Anaesth. 2001;11:541–7.

    Article  CAS  Google Scholar 

  • St-Arnaud D, Paquin MJ. Safe positioning for neurosurgical patients. AORN J. 2008;87:1156–68.

    Article  Google Scholar 

  • Winfree CJ, Kline DG. Intraoperative positioning nerve injuries. Surg Neurol. 2005;63(1):5–18.

    Article  Google Scholar 

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Heller, K.O., Vavilala, M.S., Rozet, I. (2020). Positioning the Patient for Neurosurgical Operations. In: Brambrink, A., Kirsch, J. (eds) Essentials of Neurosurgical Anesthesia & Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-17410-1_22

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  • DOI: https://doi.org/10.1007/978-3-030-17410-1_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-17408-8

  • Online ISBN: 978-3-030-17410-1

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