WITHDRAWN: Craniotomy in Semi-Sitting Position: A 4-year Single Institution Experience
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Abstract Objectives The aim of our study was to determine patient outcomes after surgery performed in the semi-sitting position in our institution in the previous 4 years. Primarily we aimed to quantify our experience in terms of surgical and anesthesia (clinical) outcomes. Secondarily we sought to evaluate any major complications that may have occurred. Background We are an academic hospital where the neurosurgical case load on average exceeds 1000 surgeries annually, with strong adherence to internationally determined clinical quality metrics. A multidisciplinary team comprising dedicated neuroanesthetists, neurophysiologists and surgical nurses, delivers care for every neurosurgical patient. As part of our neuroanesthesia departmental self-review, we retrospectively sought to assess the outcomes of patients undergoing craniotomy in sitting position from 2019 to present. The study focused on perioperative outcomes and complications associated with craniotomy in sitting position. Method The electronic medical record database was retrospectively reviewed. Beginning from 2019, all adult patients who underwent craniotomy in sitting position were included. Individual patient charts were examined for significant events during the intraoperative and postoperative period. Any critical or adverse events were recorded. Demographic and clinically important findings were tabulated in an excel sheet. The study dataset was descriptively analyzed with the quantitative data represented as mean ± standard deviation and the qualitative data as valid percentages from the total cohort. A possible parametric comparison of gender vs length of ICU stay, length of hospital stay and duration of was done using student T-test were found be non-significance at 95% confidence level. All the analysis was carried out using IBM Statistical Package for the Social Sciences (SPSS) ® Edition 22. Results A total of 10 patients underwent craniotomy in sitting position from 2019 till date. Induction and maintenance of general anesthesia were accomplished with total intravenous anesthesia using target-controlled infusion with remifentanil and propofol. The patients’ demographics, diagnosis and complications were evaluated. Nine of 10 patients had pneumocephalus with one patient developing severe manifestations. One patient had clinically significant venous air embolism with severe manifestations including massive pleural effusion. Except for one patient, all were extubated at end of surgery. Conclusions During the last four years our neuroanesthesia team recorded 10 craniotomies in sitting position. Ninety percent of patients were managed without any major long-term sequelae. We concluded that sitting position for craniotomy is not without its challenges. However, a dedicated and experienced team can manage possible complications and improve patient outcomes.
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Therefore, the authors do not wish this work to be cited as a reference. Editorial notes are used to provide important context regarding the topic of a preprint or to alert readers to potential issues concerning that preprint or a downstream publication associated with it. For more information on editorial notes, see our Editorial Policies . Abstract The full text of this preprint has been withdrawn by the authors in order to comply with an institutional policy on preprints. Therefore, the authors do not wish this work to be cited as a reference. Full Text The authors have withdrawn this preprint from Research Square. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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