为了使用半坐位 (SSP) 优化后颅窝手术 (PFS) 的手术定位，以避免静脉空气栓塞 (VAE) 及其可能危及生命的后果，作者通过分析大量 PFS 患者来评估他们使用 SSP 的经验对 2019 年至 2022 年间在 SSP 接受手术的 202 名患有各种肿瘤或血管疾病的连续 PFS 患者（中位年龄 54 岁，IQR 41-61 岁；121 名女性）的图表进行了回顾性分析。评估年龄、性别、体重、身高、BMI、美国麻醉医师协会 (ASA) 等级、组织学、手术持续时间和住院时间。术前和术中使用经食管超声心动图监测和评估 VAE 的程度。总共，202 名患者中有 30 名 (14.9%) 发生 VAE，202 名患者中有 14 名 (7%) 发生临床相关 VAE。 VAE 分级为 I、III 和 IV 级的患者分别为 16 例 (8%)、4 例 (2%) 和 10 例 (5%)。患者身高 (p = 0.04)、ASA 等级 (p = 0.03) 和 ASA 等级 ≤ II (p = 0.02) 仍然是术前 VAE 的唯一具有统计学意义的危险因素，中位身高为 178 cm (IQR 172-184)患有临床相关 VAE 的患者的身高为 170 厘米（IQR 164-176 厘米），而无 VAE 的患者则为 170 厘米（IQR 164-176 厘米）。 总之，数据表明，当特别注意优化高和矮的患者的定位时，SSP 可以安全地用于 PFS。术中 ASA 级患者。

To optimize surgical positioning for posterior fossa surgery (PFS) using the semisitting position (SSP) to avoid venous air embolism (VAE) and its possible life-threatening consequences, the authors evaluated their experiences with the SSP by analyzing a large cohort of PFS patients.A retrospective analysis of the charts of 202 consecutive PFS patients (median age 54 years, IQR 41-61 years; 121 females) with various tumor or vascular conditions who underwent surgery in an SSP between 2019 and 2022 was performed. Age, sex, weight, height, BMI, American Society of Anesthesiologists (ASA) class, histology, duration of surgery, and length of hospital stay were assessed. Transesophageal echocardiography was used pre- and intraoperatively to monitor for and assess the degree of VAE.Altogether, VAE occurred in 30 of 202 (14.9%) patients, with clinically relevant VAE occurring in 14 of 202 (7%) patients. The grades of VAE were I, III, and IV in 16 (8%), 4 (2%), and 10 (5%) patients, respectively. Patient height (p = 0.04), ASA class (p = 0.03), and ASA class ≤ II (p = 0.02) remained the only preoperative statistically significant risk factors for intraoperative VAE, with a median height of 178 cm (IQR 172-184 cm) in patients with clinically relevant VAE compared with 170 cm (IQR 164-176 cm) in those without VAE.In summary, the data demonstrate that SSP can be used safely for PFS when taking special care to optimize positioning in tall and lower-grade ASA patients intraoperatively.