Association between temporal mean arterial pressure and brachial noninvasive blood pressure during shoulder surgery in the beach chair position during general anesthesia

2015 ◽  
Vol 24 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Jacob J. Triplet ◽  
Christopher M. Lonetta ◽  
Nathan G. Everding ◽  
Molly A. Moor ◽  
Jonathan C. Levy
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Shoulder Surgery ◽  
Noninvasive Blood Pressure ◽  
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 A randomized comparative study of preloading with Ringers lactate and intravenous Ephedrine for the prevention of hypotension due to propofol during induction of general anesthesia

2016 ◽  
Vol 3 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Manisha Pradhan ◽  
Brahma Dev Jha
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Diastolic Blood Pressure ◽  
Endotracheal Intubation ◽  
Physical Status ◽  
Volume Loading

Background: The ideal method to prevent hypotension due to intravenous propofol for induction of anesthesia is still debatable. The aim of the study was to compare the hemodynamic response of ephedrine and volume loading with ringer lactate in preventing the hypotension caused by propofol as inducing agent in patients scheduled for elective surgeries requiring general anesthesia with endotracheal intubation.Methods: This was prospective randomized study conducted in 40 patients of ASA physical status I, aged 20-50 years, scheduled for elective surgeries requiring general anesthesia with endotracheal intubation. Group I received intravenous ephedrine sulphate (70 mcg/kg) just before induction of anaesthesia, and patients assigned to Group II received preloading with Ringer's lactate (12 ml/kg) over the 10-15 minutes before the administration of propofol. The variables compared were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure following induction of anesthesia till 10 minutes after intubation of trachea.Results: We found that there were increase in systolic blood pressure, diastolic blood pressure and mean arterial pressure after induction in both the groups but the difference between the groups was not significant. The increase in heart rate was found to be significantly higher in ephedrine group in comparison to volume loading group.Conclusion: Our study showed that both the methods used were equally effective in preventing hypotension induced by propofol in the adult ASA physical status I patients requiring general anesthesia with endotracheal intubation. However, the heart rate was significantly higher in patients receiving ephedrine in comparison to volume loading group.

scholarly journals Ankle-brachial blood pressure differences in the beach-chair position of the shoulder surgery

2012 ◽  
Vol 63 (6) ◽  
pp. 515 ◽  
Author(s):  
Jae Chan Choi ◽  
Jong-Hyuk Lee ◽  
Young-Don Lee ◽  
Soon Yul Kim ◽  
Sei-Jin Chang
Keyword(s):  
Blood Pressure ◽  
Shoulder Surgery ◽  
Brachial Blood Pressure ◽  
Beach Chair Position ◽  
Beach Chair

scholarly journals Effects of intraoperative hypotension on postoperative renal function in arthroscopic shoulder surgery: a retrospective study

2020 ◽  
Author(s):  
Chaeseong Lim ◽  
Seounghun Lee ◽  
Woosuk Chung ◽  
Hoseop Kim ◽  
Seungbin Jeon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Shoulder Arthroscopy ◽  
Vital Signs ◽  
Shoulder Surgery ◽  
Factors Affecting ◽  
Beach Chair Position ◽  
Intraoperative Hypotension ◽  
Arthroscopic Shoulder Surgery ◽  
Beach Chair

Abstract Background: Arthroscopic shoulder surgery tends to cause a drop in blood pressure due to the beach chair position used during the procedure, including activation of the Bezold-Jarisch reflex. We hypothesized that patients with low blood pressure undergoing arthroscopic shoulder surgery in the beach chair position would also have reduced renal function after surgery.Methods: The medical records of patients (N = 643) undergoing arthroscopic shoulder surgery in the beach chair position between July 2013 and May 2015 were examined. The vital signs were measured at 5-minute intervals, and the number of non-invasive blood pressure (NIBP) measurements in the upper arm dropping below a mean arterial pressure (MAP) of 50 mmHg (MAP50) or 60 mmHg (MAP60) were recorded. The primary outcome was change in creatinine immediately after surgery relative to the preoperative level (Cr post/pre). The factors affecting Cr post/pre were examined by correlation analysis.Results: A total of 597 patients were included in the analysis. Longer duration of hypotension during surgery (MAP50) was correlated with higher Cr post/pre (R = 0.107, P = 0.010). However, the correlation between MAP60 and Cr post/pre was not significant (R = 0.033, P = 0.431).Conclusions: It is necessary to ensure that the MAP does not fall below 50 mmHg to ensure sufficient renal function during general anesthesia for shoulder arthroscopy in a beach chair position.

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