Dynamic Lateral Semisitting Position for Supracerebellar Approaches: Technical Note and Case Series

Area of Science:

• Neurosurgery
• Surgical positioning
• Anesthesiology

Background:

• The optimal patient position for the supracerebellar approach remains debated.
• Venous air embolism (VAE) is a significant risk associated with sitting and semisitting positions during these procedures.

Purpose of the Study:

• To evaluate a dynamic lateral semisitting position for the supracerebellar approach.
• To assess the reduction in VAE and tension pneumocephalus risk.
• To leverage the advantages of the semisitting position while mitigating risks.

Main Methods:

• Eleven patients underwent supracerebellar approach surgery in the dynamic lateral semisitting position.
• Monitoring included end-tidal carbon dioxide and arterial blood pressure to detect VAE.
• Patient diagnoses varied, reflecting diverse applications of the approach.

Main Results:

• No patients experienced clinically significant venous air embolism (VAE).
• No instances of tension pneumocephalus or other major complications were recorded.
• All patients were safely extubated post-operatively.

Conclusions:

• The dynamic lateral semisitting position is a viable alternative for the supracerebellar approach.
• This position appears to reduce the risk of VAE compared to traditional positions.
• The technique combines benefits of sitting and semisitting positions with enhanced safety.