Craniotomy in Semi-sitting Position: A 4-year Single Institution Experience

We aimed to determine patient outcomes after craniotomies performed in semi-sitting position in our institution from 2019-2023. Primarily, we examined surgical and anaesthetic (clinical) outcomes. Secondarily, we evaluated any major complications that may have occurred.

Hospital records from 2019-2023 were retrospectively reviewed for adult patients who underwent craniotomy in the sitting position. Individual charts were examined for intra- and postoperative events. The demographic and clinically important findings were tabulated using Excel spreadsheet. The dataset was descriptively analyzed, with quantitative data represented as mean ± standard deviation, and qualitative data as valid percentages from the total cohort. Parametric comparisons of sex vs. (length of intensive care unit and hospital stay) and anaesthesia duration (in minutes) were performed using Student's t-test. A 95% confidence level was used to determine statistical significance. Analyses were performed using IBM SPSS^® Edition 22.

From 2019-2023, 10 patients underwent craniotomy in a sitting position. General anaesthesia was induced and maintained using an intravenous target-controlled infusion of remifentanil and propofol. Nine patients developed pneumocephalus, with one developing increased intracranial pressure. One patient had a significant venous air embolism with severe manifestations, including massive pleural effusion. All patients except one were extubated at the end of the surgery.

Of the 10 craniotomies performed in the sitting position from 2019-2023, 90% were managed without major long-term sequelae. Although the sitting position for craniotomies is not without challenges, a dedicated and experienced team can manage complications and improve patient outcomes.