Posterior fossa tumor surgeries are challenging from the point of view of both surgeons and anesthetists owing to the proximity of the tumor to vital centers, the difficulty faced in approaching the tumor, and complications associated with the positioning. The challenge in this patient undergoing a sitting-position craniotomy for a left-sided acoustic schwannoma was further augmented by the presence of a complete heart block in our patient (for which a pacemaker had been inserted) and the co-existence of a moderate aortic regurgitation.
Jagannathan S, Krovvidi H. Anaesthetic considerations for posterior fossa surgery. Cont Edu Anaest Crit Care & Pain 2014;14(5):202–206. DOI: 10.1093/bjaceaccp/mkt056.
Jindal P, Kapoor R, Khurana G, et al. Safety profile in a parturient with permanent pacemaker who underwent successive lower segment cesarean section under spinal anesthesia. J Obstet Anaest Crit Care 2013;3(2):94. DOI: 10.4103/2249-4472.123305.
Halgunaki P, Karthik G, Rangalakshmi, et al. Anesthetic Management of an Elderly Patient with Permanent Pacemaker posted for Fixation of Tibial and Radial Fracture. J Med Sci 2015;1:77–79. DOI: 10.5005/jp-journals-10045-0023.
Bansal T, Jaiswal R, Hooda S. Anaesthetic implications and considerations in a child with pacemaker posted for colostomy closure: a case report. Ped Anest Crit Care J 2015;3(1):38–40.
Panigrahi M, Patibandla M, Gurram P, et al. Morphometric analysis of posterior fossa in Indian CP angle acoustic schwannoma patients. Asian J Neurosurg 2016;11(3):255. DOI: 10.4103/1793-5482. 145308.
Drummond JC, Patel PM, Lemkuil BP. Anesthesia for Neurologic Surgery. Miller RD. Miller's Anesthesia, 8th ed., Philadelphia, PA: Churchill Livingstone/Elsevier; 2015. pp. 2158–2199.
Porter J, Pidgeon C, Cunningham A. The sitting position in neurosurgery: a critical appraisal. Br J Anaesth 1999;82(1):117–128. DOI: 10.1093/bja/82.1.117.
Nussmeier N, Sarwar M, Searles B, et al. Anesthesia for Cardiac Surgical Procedures. Miller R, Cohen N, Eriksson L, et al. Miller's Anesthesia, 8th ed., Philadelphia: Elsevier Inc.; 2015. pp. 2007–2091.
Rastogi S, Goel S, Tempe D, et al. Anaesthetic management of patients with cardiac pacemakers and defibrillators for noncardiac surgery. Ann Card Anaesth 2005 Jan;8(1):21–32.
Crossley G, Poole J, Rozner M, et al. The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management this document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Heart Rhythm 2011 Jul;8(7):1114–1154. DOI: 10.1016/j.hrthm.2010.12.023.