Perioperative Considerations and Positioning for Neurosurgical Procedures: A Clinical Guide

Description

There are relationships that exist between neuroanesthesia, neurosurgical procedures, individual patient pathology and the positioning of a patient for said procedure. A comprehensive examination of these relationships, their association with patient morbidity/mortality and how to approach these issues in an evidence-based manner has yet to become available. Positioning related injuries have been documented as major contributors to neurosurgical/neuroanesthesiology liability. This text examines these relationships. It provides considerations necessary to the correct positioning of a patient for a neurosurgical procedure for each individual patient and their individual pathology. In other words, this text will demonstrate how to construct the necessary surgical posture for the indicated neurosurgical procedure given the individual constraints of the patient within the environment of anesthesia and conforming to existing evidence-based practice guidelines. Sections will address physiological changes inherent in positioning in relation to anesthesia for neurosurgical procedures, assessment of patient for planned procedure, as well as considerations for managing problems associated with these relationships. Additional sections will examine the relationship between neurosurgical positioning and medical malpractice and the biomechanical science between positioning devices and neurosurgical procedures. Neurosurgery and its patient population are in a constant state of change. Providing the necessary considerations for the neurosurgical procedure planned under the anesthesia conditions planned in the position planned, often in the absence of multicase study literary support, without incurring additional morbidity is the goal of this text. Front Matter ....Pages i-xix Positioning Patients for Neurosurgical Procedures: A Historical Perspective (Mallory Roberts, Jon H. Robertson)....Pages 1-18 Biomechanics and the Mathematics of Positioning (George F. Young)....Pages 19-25 Anesthesia and Patient Positioning (C. Wayne Hamm)....Pages 27-50 Preoperative Assessment of the Patient for the Planned Position (C. Wayne Hamm, Jaafar Basma)....Pages 51-63 Organization of the Operating Room for Neurosurgical Procedures (Jaafar Basma, Daniel Hoit)....Pages 65-79 Overall Positioning Considerations for Intracranial Procedures (Adam Arthur)....Pages 81-82 Intracranial Procedures in the Supine, Semi-Sitting, and Sitting Positions (Jaafar Basma, Vincent Nguyen, Jeffrey Sorenson)....Pages 83-100 Intracranial Procedures in the Lateral Position (L. Madison Michael II, Douglas R. Taylor)....Pages 101-110 Intracranial Procedures in the Prone Position (Mirza Pojskic, Kenan I. Arnautovic)....Pages 111-131 Spinal Surgery Positioning Overview (Kevin Foley)....Pages 133-135 The Supine, Sitting, and Lithotomy Positions (Shaheryar F. Ansari, Jean-Pierre Mobasser)....Pages 137-147 Spinal Procedures in the Lateral Position (Matthew T. Brown, Raul Cardenas, Julius Fernandez)....Pages 149-158 Spinal Procedures in the Prone Position (Prayash Patel, Christopher Nickele)....Pages 159-174 Special Considerations in Positioning for Neurosurgical Tumors: Spinal (Jason A. Weaver)....Pages 175-190 Special Considerations for Intracranial Tumors (Pascal O. Zinn, Ganesh Rao)....Pages 191-204 Special Considerations for Pediatric Positioning for Neurosurgical Procedures (Michael DeCuypere)....Pages 205-212 Comorbidities and Positioning: Morbid Obesity and Multiple Trauma (Emily P. Sieg, Shelly D. Timmons)....Pages 213-222 Comorbidities and Positioning: Pregnancy (Thomas Scott Guyton)....Pages 223-239 Postoperative Positioning in the Neurointensive Care Unit (Abhi Pandhi, Lucas Elijovich)....Pages 241-249 Differential Diagnosis, Treatment, and Prognosis of Peripheral Nerve Injuries Associated with Neurosurgical Procedures (Nickalus R. Khan, Michael S. Muhlbauer)....Pages 251-264 Legal Issues in Patient Positioning (Emily Hamm Huseth)....Pages 265-278 Back Matter ....Pages 279-287