Charbel F, Kehrli P, Pain L
Department of Neurosurgery, Neuropsychiatric Institute University of Illinois, Chicago 60612, USA.
Ann Fr Anesth Reanim. 1998;17(2):160-3. doi: 10.1016/s0750-7658(98)80067-1.
The sitting position offers the benefits of better access to the apex of the posterior fossa, and an improved exploration and dissection because blood and cerebral spinal fluid drain away from the operative site. Specific complications of the sitting position include cardiovascular instability, jugular venous obstruction, airway oedema, quadriplegia, displacements of catheters and the endotracheal tube, ulnar, sciatic and lateral peroneal nerve compression, venous air embolism, and tension pneumocephalus. In the only existing comparative study, the differences were an increased bleeding in the horizontal position and a better cranial nerve preservation in the sitting position. This argues strongly for teaching and use of the sitting position whenever surgically indicated.
坐位具有更好地暴露后颅窝顶部的优势，并且由于血液和脑脊液从手术部位引流，有助于改善探查和解剖。坐位的特定并发症包括心血管不稳定、颈静脉阻塞、气道水肿、四肢瘫痪、导管和气管内导管移位、尺神经、坐骨神经和腓总神经受压、静脉空气栓塞和气颅。在仅有的一项比较研究中，差异在于水平位出血增加，而坐位对脑神经的保留更好。这有力地支持了在手术指征明确时教授和采用坐位。
