Age-related differences in cognition and postoperative quality of recovery after beach chair position shoulder surgery

2021 ◽  
pp. 0310057X2110203
Author(s):  
Alwin Chuan ◽  
Minh T Tran ◽  
Alice X Sun ◽  
Tajrian Amin ◽  
Yan X Chan ◽  
...  
Keyword(s):  
Older Patients ◽  
Shoulder Surgery ◽  
Functional Activities ◽  
Quality Of Recovery ◽  
Beach Chair Position ◽  
Management Protocol ◽  
Significant Difference ◽  
Postoperative Quality ◽  
Beach Chair

We examined the influence of age in beach chair position shoulder surgery and postoperative quality of recovery by conducting a single-site, observational, cohort study comparing younger aged (18–40 years) versus older aged (at least 60 years) patients admitted for elective shoulder surgery in the beach chair position. Endpoints were dichotomous return of function to each patient’s individual preoperative baseline as assessed using the postoperative quality of recovery scale; measuring cognition, nociception, physiological, emotional, functional activities and overall perspective. We recruited 112 (41 younger and 71 older aged) patients. There was no statistical difference in cognitive recovery at day three postoperatively (primary outcome): 26/32 younger patients (81%) versus 43/60 (72%) older patients, P=0.45. Rates of recovery were age-dependent on domain and time frame (secondary outcomes), with older patients recovering faster in the nociceptive domain ( P=0.02), slower in the emotional domain ( P=0.02) and not different in the physiological, functional activities and overall perspective domains (all P >0.35). In conclusion, we did not show any statistically significant difference in cognitive outcomes between younger and older patients using our perioperative anaesthesia and analgesia management protocol. Irrespective of age, 70% of patients recovered by three months in all domains.

scholarly journals Improved Quality of Recovery from Ambulatory Shoulder Surgery After Implementation of a Multimodal Perioperative Pain Management Protocol

Pain Medicine ◽  
2018 ◽  
Vol 20 (5) ◽  
pp. 1012-1019 ◽  
Author(s):  
Nabil M Elkassabany ◽  
Anthony Wang ◽  
Jason Ochroch ◽  
Matthew Mattera ◽  
Jiabin Liu ◽  
...  
Keyword(s):  
Pain Management ◽  
Shoulder Surgery ◽  
Quality Of Recovery ◽  
Perioperative Pain ◽  
Management Protocol ◽  
Perioperative Pain Management

scholarly journals A randomized trial of desflurane or sevoflurane on postoperative quality of recovery after knee arthroscopy

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0220733
Author(s):  
Stuart Boggett ◽  
Jared Ou-Young ◽  
Johan Heiberg ◽  
Richard De Steiger ◽  
Martin Richardson ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Knee Arthroscopy ◽  
Quality Of Recovery ◽  
Postoperative Quality

scholarly journals Hoarseness After Shoulder Surgery in Beach-chair Position

2021 ◽  
Author(s):  
Seung-Min Youn ◽  
Sung-Min Rhee ◽  
Hwan Jin Kim ◽  
Hyun Woo Lee ◽  
Seong Cheol Moon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Vocal Cord ◽  
Recovery Time ◽  
Shoulder Surgery ◽  
Worst Case ◽  
Beach Chair Position ◽  
Cord Injury ◽  
Spine Radiographs ◽  
Beach Chair

Abstract Background Isolated vocal cord palsy resulting hoarseness after shoulder surgery in beach-chair position had not been reported in literature to date. The purpose of this study was to review its incidence in our patient cohort, and identify any risk factors that may predispose the patient to the injury.Methods There were 10215 operative shoulder cases from January 2010 to December 2017. Inclusion criteria was any post-operative patients, whose operation was performed under general anesthesia in beach-chair position, who had the related symptoms, but the diagnoses had to be confirmed by otorhinolaryngologists with laryngoscopy studies. The affected patients’ clinical notes were retrospectively reviewed with the particular interest in the operative times, and the peri-operative cervical spine radiographs. The degree of cervical spine lordosis was assessed using a method described in literature, in which ‘absolute rotation angle’ (ARA) was measured. Results There were 8 reported cases of vocal cord injury in total (0.08%). Four were male patients and four were arthroscopic cases. The mean age was 59.4 ± 11.9 years old. No particular difficulties with positioning or intubation were documented. The average duration of anesthetic times was 141 minutes. On peri-operative cervical spine radiographs, the average lordosis was 8.2° (1.5° kyphosis - 21° lordosis), and except for one patient, all had ‘non-lordotic’ type curvatures. All but one patient had recovered fully with observation and expectant management, with the average recovery time being 19 weeks (range: 2 weeks to 1 year). Only patient who had not recovered during our 2-year follow-up period, had a ‘sigmoidal’ type cervical spine and was also managed with observation only.Conclusions The incidence of vocal cord injury with beach-chair positioning at our institution was low at 0.08%. The possible risk factors include long duration of the procedure and ‘non-lordotic’ cervical spine, as demonstrated by the trend in our study. Although rare, vocal cord injury has varying duration of recovery time, in the worst-case scenario being permanent, therefore it needs to be avoided by taking utmost care during positioning of the patient in beach-chair. Level of Evidence Level IV, case series

scholarly journals Impact of Aquatic Exercise on Respiratory Outcomes and Functional Activities in Children with Neuromuscular Disorders: Findings from an Open-Label and Prospective Preliminary Pilot Study

2020 ◽  
Vol 10 (7) ◽  
pp. 458
Author(s):  
Marta Huguet-Rodríguez ◽  
José Luis Arias-Buría ◽  
Belén Huguet-Rodríguez ◽  
Rocío Blanco-Barrero ◽  
Daniel Braña-Sirgo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Repeated Measures ◽  
Neuromuscular Disorders ◽  
Analysis Of Covariance ◽  
Aquatic Exercise ◽  
Functional Skills ◽  
Functional Activities ◽  
Significant Difference ◽  
Respiratory Outcomes

Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4–18 years, Vignos scale 1–9) were involved in a 10-week aquatic exercise program. The ventilation variables were: peak cough flow, volumes (forced expiratory volume in one second-FEV1 and inspiratory volume) and respiratory pressures to evaluate strength and oxygen saturation (O2 sat). Functional skills were measured in the aquatic environment (Water Orientation Test Alyn 1) and on dry land, (Pediatric Evaluation of Disability Inventory), together with quality of life (Pediatric Quality of Life Inventory). Our evaluation included several 2 × 6 mixed-model repeated measures analysis of covariance (ANCOVA) with time (baseline, post 1 session, pre-post at five weeks and pre-post at 10 weeks). Important improvements in functional skills were observed in and out of the water and children under the age of 11 displayed a significant difference for inspirational volume (p = 0.002) and O2 sat (p = 0.029). Clinical, statistically insignificant changes were found for peak cough flow and expiratory pressures values after aquatic exercise. These results may support a relationship between aquatic exercise in NMD, respiratory outcomes and functional activities in water and on land.

scholarly journals More hypotension in patients taking antihypertensives preoperatively during shoulder surgery in the beach chair position

2011 ◽  
Vol 58 (11) ◽  
pp. 993-1000 ◽  
Author(s):  
Terrence L. Trentman ◽  
Sharon L. Fassett ◽  
Justin K. Thomas ◽  
Brie N. Noble ◽  
Kevin J. Renfree ◽  
...  
Keyword(s):  
Shoulder Surgery ◽  
Beach Chair Position ◽  
Beach Chair
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