What are the contraindications to the sitting position?
There are no strict contraindications; however,
each patient requires careful evaluation to determine the feasi-bility of
positioning and risks for complications. Specific contraindications involve the
presence of a patent foramen ovale or suspected intracardiac shunt. Other
conditions which may predispose to development of complications are hemodynamic
instability or noted cerebral compromise when sitting upright preoperatively.
Other concerns involve positioning of the neck, which may compromise spinal
cord perfusion in the patient with severe cervical arthritis. The sitting
position is being used less frequently today as neuro-surgeons attempt to avoid
the inherent problems associated with its use. Many surgeons now employ the
lateral, prone, or supine position with the head turned.
Monitors for Detection of Venous Air Embolism
Doppler Transesophageal echocardiography Mass spectrometry (end-tidal N2)