Preprint Article Version 1 This version is not peer-reviewed

Influence of Patient Position-Related Differences in Intra- and Postoperative Implications on Major Anesthesia Parameters in Posterior Fossa Surgery

Version 1 : Received: 16 September 2024 / Approved: 16 September 2024 / Online: 17 September 2024 (10:42:30 CEST)

How to cite: Radu, O. M.; Balaci, G. M.; Leucuța, D. C.; Moisescu, V. I.; Munteanu, C.; Florian, S. I. Influence of Patient Position-Related Differences in Intra- and Postoperative Implications on Major Anesthesia Parameters in Posterior Fossa Surgery. Preprints 2024, 2024091306. https://doi.org/10.20944/preprints202409.1306.v1 Radu, O. M.; Balaci, G. M.; Leucuța, D. C.; Moisescu, V. I.; Munteanu, C.; Florian, S. I. Influence of Patient Position-Related Differences in Intra- and Postoperative Implications on Major Anesthesia Parameters in Posterior Fossa Surgery. Preprints 2024, 2024091306. https://doi.org/10.20944/preprints202409.1306.v1

Abstract

Background/Objectives: Patient positioning during surgery can influence intra- and postoperative complications. Therefore, we assessed the impact of the sitting and park-bench positions on anesthetic parameters and complications in neurosurgical patients. Methods & Patients: For this retrospective study, 314 adults who underwent neurosurgical procedures for posterior fossa pathologies were divided into two groups: sitting (n=231) and park bench (n=83). The following data were collected, monitored, recorded and compared: age, sex, tumor type, surgical approach, cardiovascular and respiratory complications, and postoperative surgical complications. The association of hypotension with position was further investigated through multivariate logistic regression models by adjusting for CO2 decrease, desaturation and documented gas embolism. Results: The average age was significantly lower in the sitting group (55 years, interquartile range (IQR)=43-63; female proportion=59.74%) than in the park-bench group (62 years, IQR=45-74; female proportion=57.83%) (p<0.001). Cerebellopontine angle tumors were detected in 37.23% of the patients who underwent operation in the sitting position and in 7.26% who underwent operation on in the park-bench position (p<0.001). Patients in the sitting position had significantly greater anesthetic complication (91.77% vs. 71.08%, p<0.001), hypotension (61.9% vs. 16.87%),and >2-mmHg CO2 decrease (35.06% vs. 15.66%, p<0.001) incidences. Hypoxemia and death occurred more frequently in the park-bench group (8.43% vs. 1.73% and 6.03% vs. 1.3%, respectively). Conclusions: Compared with the park-bench position, the sitting position was associated with a greater specific anesthetic complication incidence and lower postoperative mortality rate, indicating a need for careful risk‒benefit assessment when selecting each individual patient’s surgical position.

Keywords

hemodynamic implications; venous air embolism; sitting position; park-bench position; EtCO2; pneumocephalus; postoperative hematoma

Subject

Medicine and Pharmacology, Clinical Medicine

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0


×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.