Sitting position for pineal surgery: Some anaesthetic considerations

Neurochirurgie. 2015 Apr-Jun;61(2-3):164-7. doi: 10.1016/j.neuchi.2014.10.110. Epub 2015 Feb 9.

Abstract

Introduction: The sitting position for pineal tumour removal remains controversial as regards the number of potential complications despite good surgical conditions.

Method: A systematic review of the literature was conducted in order to record the most frequent complications observed in this position, their incidence and prevention.

Results: Venous air embolism, hypotension, pneumocephalus, macroglossia, quadriplegia and nerve injuries are the most frequent complications observed. Their incidence can be dramatically decreased with an accurate anesthesiological and neurosurgical management.

Conclusion: In training teams, the sitting position remains the gold standard for pineal tumour removal.

Keywords: Anaesthesia; Anesthésie; Embolie gazeuse; Foramen ovale; Hypotension; Pineal tumor; Position assise; Sitting position; Tumeur pinéale; Venous air embolism.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anesthetics* / adverse effects
  • Embolism, Air*
  • Humans
  • Intraoperative Complications / prevention & control*
  • Monitoring, Intraoperative / methods
  • Neurosurgical Procedures*
  • Pineal Gland / surgery*

Substances

  • Anesthetics