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Chapter: Clinical Cases in Anesthesia : Intracranial Mass, Intracranial Pressure, Venous Air Embolism, And Autoregulation

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.

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

 

·           Precordial Doppler Transesophageal echocardiography Mass spectrometry (end-tidal N2)

·           Capnography (ETCO2)

·           Pulse oximetry (SpO2)

·           Central venous pressure

·           Pulmonary artery pressure

·           Esophageal stethoscope

 

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Clinical Cases in Anesthesia : Intracranial Mass, Intracranial Pressure, Venous Air Embolism, And Autoregulation : What are the contraindications to the sitting position? |


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