Key result
Valsalva manoeuvre fails to reliably predict upright tolerance during neurosurgery due to likely false negatives.
Why the study?
The reliability of the Valsalva manoeuvre to predict patient tolerance of upright or sitting position during neurosurgical procedures under anaesthesia was uncertain.
Does the Valsalva manoeuvre reliably predict a patient's ability to tolerate the upright or sitting position for neurosurgical procedures under anaesthesia?
Observational
Does the Valsalva manoeuvre reliably predict a patient's ability to tolerate the upright or sitting position for neurosurgical procedures under anaesthesia?
The Valsalva manoeuvre should not be relied upon to predict whether a patient can tolerate upright positioning during neurosurgical procedures under anaesthesia.
Answers are grounded in this paper and cite their sources.
Caution against using Valsalva to guide neurosurgical positioning; hypothesis-generating and requires prospective validation.
The four phases of the Valsalva manoeuvre were studied before and after anaesthesia had been induced with a technique of either spontaneous breathing or controlled ventilation of the lungs. The Valsalva manoeuvre was found to be an unreliable predictor of a patient's ability to tolerate the upright or sitting position for neurosurgical procedures. However, a false negative response is more likely to occur than a false positive response.
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Rawlinson et al. (1979) conducted an observational in Patients undergoing neurosurgical procedures. Valsalva manoeuvre was evaluated on Ability to tolerate the upright or sitting position. The Valsalva manoeuvre is an unreliable predictor of a patient's ability to tolerate the upright or sitting position for neurosurgical procedures, with false negatives being more likely.
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