The beach chair position for shoulder surgery in intravenous general anesthesia and controlled hypotension: Impact on cerebral oxygenation, cerebral blood flow and neurobehavioral outcome

2019 ◽  
Vol 53 ◽  
pp. 40-48 ◽  
Author(s):  
José A. Aguirre ◽  
Fabian Etzensperger ◽  
Muriel Brada ◽  
Sandra Guzzella ◽  
Andrea Saporito ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
General Anesthesia ◽  
Cerebral Oxygenation ◽  
Shoulder Surgery ◽  
Controlled Hypotension ◽  
Beach Chair Position ◽  
Intravenous General Anesthesia ◽  
Beach Chair ◽  
Neurobehavioral Outcome

The effect of the beach-chair position angle on cerebral oxygenation during shoulder surgery

2017 ◽  
Vol 26 (9) ◽  
pp. 1670-1675 ◽  
Author(s):  
Chad E. Songy ◽  
Eric R. Siegel ◽  
Mark Stevens ◽  
John T. Wilkinson ◽  
Shahryar Ahmadi
Keyword(s):  
Cerebral Oxygenation ◽  
Position Angle ◽  
Shoulder Surgery ◽  
Beach Chair Position ◽  
Beach Chair

scholarly journals Cerebral Oxygen Saturation Measured by Near-infrared Spectroscopy and Jugular Venous Bulb Oxygen Saturation during Arthroscopic Shoulder Surgery in Beach Chair Position under Sevoflurane-Nitrous Oxide or Propofol-Remifentanil Anesthesia

2012 ◽  
Vol 116 (5) ◽  
pp. 1047-1056 ◽  
Author(s):  
Hyejin Jeong ◽  
Seongtae Jeong ◽  
Hoi J. Lim ◽  
JongUn Lee ◽  
Kyung Y. Yoo
Keyword(s):  
Nitrous Oxide ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Cerebral Oxygenation ◽  
Shoulder Surgery ◽  
Tissue Oxygen Saturation ◽  
Beach Chair Position ◽  
Beach Chair ◽  
Jugular Venous Bulb

Background We examined the effects of different anesthetics on cerebral oxygenation and systemic hemodynamics in patients undergoing surgery in beach chair position (BCP). Jugular venous bulb oxygen saturation (SjvO2) and regional cerebral tissue oxygen saturation (SctO2) were determined while patients were placed from the supine to BCP. Whether SctO2 and SjvO2 are interchangeable in assessing the cerebral oxygenation was also examined. Methods Forty patients undergoing shoulder surgery in BCP were randomly assigned to receive sevoflurane-nitrous oxide (S/N) or propofol-remifentanil (P/R) anesthesia. Four patients taking angiotensin II receptor antagonists were excluded post hoc. Mean arterial pressure and heart rate, as well as SjvO2 and SctO2, were measured before (postinduction baseline in supine position) and after BCP. Results Mean arterial pressure decreased by BCP in both groups. It was, however, significantly higher in S/N (n = 19) than in P/R group (n = 17) at 7 to 8 min after the positioning. SjvO2 also significantly decreased after BCP in both groups, the magnitude of which was lower in S/N than in P/R group (11 ± 10% vs. 23 ± 9%, P = 0.0006). The incidences of SjvO2 <50% and mean arterial pressure less than 50 mmHg were lower in S/N group, but SctO2and the incidence of cerebral desaturation (more than 20% decrease from baseline) did not significantly differ between the groups. SctO2 and SjvO2 were only weakly correlated (β = 0.218, r2 = 0.133). Bland-Altman analysis showed a mean difference of -7.2% with 95% limit of agreement between -38.2% and 23.8%. Conclusions The margin of safety against impaired cerebral oxygenation is greater and SjvO2 is more preserved with S/N than with P/R anesthesia. SctO2 may not be reliable in detecting a low SjvO2 during the surgery in BCP.

scholarly journals Patient state index and cerebral blood flow changes during shoulder arthroscopy in beach chair position

2016 ◽  
Vol 66 (5) ◽  
pp. 470-474
Author(s):  
Mehmet Ilke Buget ◽  
Ata Can Atalar ◽  
Ipek Saadet Edipoglu ◽  
Zerrin Sungur ◽  
Nukhet Sivrikoz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Shoulder Arthroscopy ◽  
Beach Chair Position ◽  
Patient State ◽  
State Index ◽  
Flow Changes ◽  
Patient State Index ◽  
Beach Chair
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