Prospective data was collected on 58 patients having neurosurgery in the sitting position in one institution. The incidence of venous air embolism was 43% (25/58), of which the majority were small or moderate in size. There were no episodes of paradoxical air embolism. The incidence of other intraoperative and postoperative complications was low. There was no mortality or serious morbidity. With a proper understanding of the pathophysiology of venous air embolism and the use of sensitive monitoring, anaesthesia for sitting position neurosurgery can be provided safely.
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