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British Journal of Anaesthesia, 2002, Vol. 88, No. 1 1-3
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial I

The sitting position in neurosurgery—not yet obsolete!

I.E. Leonard and A.J. Cunningham

The 1960s and the 1970s were the heyday for the popularity of the sitting position for surgical procedures involving the cervicodorsal spine and the posterior and lateral cranial fossae.1 This patient position provides optimum access to midline lesions, improves cerebral venous decompression, lowers intracranial pressure (ICP), and promotes gravity drainage of blood and cerebral spinal fluid (CSF).2 Accumulated blood drains out of and away from the operative site in the sitting position, permitting more rapid access to bleeding points, a cleaner surgical field and a technically easier procedure than is possible in the prone position. In addition, the sitting position provides an unobstructed view of the patient’s face, enabling observation of motor responses to cranial nerve stimulation. In some procedures, notably supracerebellar, infratentorial approaches to the pineal gland, the sitting position minimizes the amount of cerebellar retraction needed to gain access to deeper structures. Complications related to the use of . . . [Full Text of this Article]

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