Articles: general-anesthesia.
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Sitting position during surgery of the posterior fossa is very convenient for the neurosurgeon but can be dangerous, specially concerning the risk of air-embolism. We discuss the major problems of this special position, and the modifications of respiratory and hemodynamic functions from our experience on 84 cases. We study the monitoring of these patients during surgery, with special emphasis on prevention and detection of air-embolism with the capnograph. With the protocol suggested we can avoid major risk in this position.
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An increased venous capacity and a decreased myocardial contractility can be expected in patients with an acute spinal cord lesion at or above T6. Both factors may contribute to a high incidence of arterial hypotension and pulmonary oedema in these patients especially during anaesthesia. ⋯ V. P. measurement and is particularly useful in patients with a sympathectomy secondary to spinal cord trauma.