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This trial randomized 56 patients undergoing endoscopic endonasal pituitary surgery to semisitting or supine positioning (28 per group). Mean blood loss was 184.7 versus 277.3 mL, a reduction of 92.6 mL (33.4%; P = 0.03). Intraoperative interruptions were also lower with semisitting positioning (rate ratio, 0.80; P = 0.03). Venous air embolism occurred in 3 patients (10.7%) in the semisitting group and none in the supine group; all events resolved spontaneously. Conclusion: Semisitting positioning reduced bleeding and interruptions, but the small trial warrants further safety evaluation.

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This trial randomized 56 patients undergoing endoscopic endonasal pituitary surgery to semisitting or supine positioning (28 per group). Mean blood loss was 184.7 versus 277.3 mL, a reduction of 92.6 mL (33.4%; P = 0.03). Intraoperative interruptions were also lower with semisitting positioning (rate ratio, 0.80; P = 0.03). Venous air embolism occurred in 3 patients (10.7%) in the semisitting group and none in the supine group; all events resolved spontaneously. Conclusion: Semisitting positioning reduced bleeding and interruptions, but the small trial warrants further safety evaluation.
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