Safety of Beach Chair Position Shoulder Surgery: A Review of the Current Literature.

Safety of Beach Chair Position Shoulder Surgery: A Review of the Current Literature.
Anesth Analg. 2019 Apr 03;:
Authors: Murphy GS, Greenberg SB, Szokol JW
Abstract
Although uncommon, severe neurological events have been reported in patients undergoing shoulder surgery in the beach chair position. The presumed etiology of central nervous system injury is hypotension and subsequent cerebral hypoperfusion that occurs after alterations in positioning under general anesthesia. Most clinical trials have demonstrated that beach chair positioning results in reductions in regional brain oxygenation, cerebral blood flow, and jugular bulb oxygenation, as well as impairment in cerebral autoregulation and electroencephalographic/processed electroencephalographic variables. Further studies are needed to define the incidence of adverse neurological adverse events in the beach chair position, identify the best intraoperative neurological monitors that are predictive of neurocognitive outcomes, the lowest "safe" acceptable blood pressure during surgery for individual patients, and the optimal interventions to treat intraoperative hypotension.
PMID: 30973381 [PubMed - as supplied by publisher]

Source: Anesthesia and Analgesia - April 2, 2019 Category: Anesthesiology Authors: Murphy GS, Greenberg SB, Szokol JW Tags: Anesth Analg Source Type: research