ANESTHESIA MANAGEMENT IN POSTERIOR FOSSA SURGERY: A COMPARISON OF SITTING AND PARK-BENCH POSITIONS

Background & Aims: Patient positioning in posterior fossa surgery significantly affects intraoperative anesthetic management and postoperative outcomes. This study compares the anesthetic implications, complications, and clinical outcomes of the sitting and park-bench positions in patients undergoing posterior fossa surgery. Methods: A retrospective analysis of 300 adult patients undergoing posterior fossa surgery was conducted. Patients were categorized into two groups: sitting position (n = 220) and park-bench position (n = 80). Intraoperative variables, including hemodynamic stability, venous air embolism (VAE) incidence, CO₂ variations, and postoperative complications, were analyzed. Multivariate logistic regression was used to adjust for confounders. Results: The sitting position was associated with higher anesthetic complication rates (91.77% vs. 71.08%, p < 0.001), increased hypotension (61.9% vs. 16.87%, p < 0.001), and greater CO₂ decrease (35.06% vs. 15.66%, p < 0.001). However, postoperative mortality was higher in the park-bench position (6.03% vs. 1.3%, p < 0.05). Hypoxemia (8.43% vs. 1.73%, p < 0.05) and prolonged mechanical ventilation were also more frequent in the park-bench group. Conclusions: The sitting position presents a higher risk of intraoperative anesthetic complications but is associated with lower postoperative mortality. These findings highlight the importance of individualized positioning strategies in posterior fossa surgery