Air Embolism During Neurosurgery

Abstract

During a seven-year period, 2,002 neurosurgical procedures were done with the patients in the sitting position. Forty episodes of air embolism were recognized in 32 of these patients and all but one episode occurred during surgery on the posterior cranial fossa. In 18 patients, a catheter had been previously placed in the right atrium (21 episodes) or superior vena cava (two episodes). In all of these, the diagnosis was confirmed by the aspiration of volumes of air varying from 2 to 400 ml. During eight of the episodes, volumes exceeding 10 ml of air were aspirated. This experience supports a recommendation for placement of a catheter in the right atrium prior to surgical procedures likely to be complicated by air embolism.