Alleviation of intracranial air using carbon dioxide gas during intraventricular tumor resection

Postoperative vomiting occurs more frequently in patients after intraventricular surgery than after other intracranial surgeries. This has been attributed to intracranial air. Carbon dioxide gas (CO2) has properties beneficial to the treatment of some medical disorders, displaying a higher specific gravity and more rapid absorption into surrounding tissues than air. We therefore, attempted to replace air with CO2 during intra- and paraventricular tumor resections. The aim of the present study was to elucidate whether intracranial air after intraventricular surgery could be alleviated safely using CO2, and investigate its clinical usefulness.

CO2 was introduced into the subdural space at 2l/min through a silicon tube from time of dural incision to closure. Subjects comprised 40 patients alternately assigned to one of two groups: the trial group (n=20) receiving CO2 treatment; and controls (n=20) without CO2 treatment.

Intra- and postoperatively, no patients showed complications caused by CO2 treatment. Postoperatively, intraventricular gas shown on CT scans disappeared significantly sooner in the trial group than in controls. Frequency of postoperative vomiting was significantly lower in the trial group than in controls.

Intracranial air after intraventricular surgery can be safety alleviated using CO2.