Venous Air Embolism Associated Morbidity and Mortality in Patients Undergoing Neurosurgical Procedures in the Sitting Position

Subhi M. Al- Ghanem, Abdelkareem S. Al- Oweidi, Walid S. Maani, Ahmad F. Tamimi


Objectives: To identify the morbidity and the mortality related to Venous Air Embolism (VAE) during posterior fossa surgery in the sitting position.

Methods: This study was conducted at Jordan University Hospital, Amman, Jordan. Records of 73 patients undergoing posterior fossa surgery in the sitting position from 1990 to 2005 were retrospectively reviewed to determine the incidence of VAE, the nature of perioperative morbidity and mortality and their relation to VAE.

Results: The incidence of VAE was 13.5%. Intraoperative hypotension secondary to VAE was (9.6%). Intraoperative hypotension was 19% during the positioning of patients and 29% during the procedures. Patients who received blood transfusion were 10 (19.2%) children and 5 (9.6%) adults. Average blood transfusion in children was 200 mls and 360 mls in adults.

Postoperatively, six (11.5%) patients were electively intubated and ventilated. Postoperative evacuation of posterior fossa haematoma was performed in seven (13.5%) patients. Six (11.5%) patients died within one month after surgery. There was no intraoperative or postoperative morbidity or mortality related to VAE.

Conclusion: Our results indicate the absence of morbidity and mortality related to VAE. With early detection and prompt treatment of VAE, the sitting position is safe for neurosurgical procedures.


posterior fossa surgery, anesthesia, venous air embolism

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