Haemodynamics and cerebral oxygenation during arthroscopic shoulder surgery in beach chair position under general anaesthesia

Acta Anaesthesiologica Scandinavica
H JeongK Y Yoo

Abstract

Patients undergoing surgery in beach chair position (BCP) are at risk of cerebral ischaemia. We determined the prevalence and risk factors of jugular venous bulb oxygen desaturation (SjvO(2)  < 50%) in BCP. It was also examined whether regional cerebral tissue oxygen saturation (SctO(2) ) measured by near-infrared spectroscopy and SjvO(2) are interchangeable for assessment of cerebral oxygenation. Fifty-six consecutive patients undergoing arthroscopic shoulder surgery in BCP were studied. Anaesthesia was intravenous with propofol and remifentanil (P/R) or inhalational with sevoflurane and 50% nitrous oxide (S/N) depending on provider choice. Mean arterial pressure (MAP), heart rate (HR), SjvO(2) , and SctO(2) were measured before (baseline; post-induction in supine position) and after the patients assumed BCP. Bland-Altman analysis was performed to measure the agreement between SctO(2) and SjvO(2) . SjvO(2) , SctO(2) , MAP, and HR decreased significantly when patients were raised into BCP. Jugular desaturation occurred in 41% of patients (56% with P/R vs. 21% with S/N anaesthesia, P = 0.0077). Risk factors for the desaturation included P/R anaesthesia [adjusted odds ratio (aOR) 4.76, 95% confidence interval (CI) 1.34-16.95, P =...Continue Reading

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Citations

Feb 26, 2013·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Sep 21, 2013·Journal of Clinical Monitoring and Computing·Youn Yi JoHyun Jeong Kwak
Nov 12, 2013·Primary Care·Viviane Bishay, Robert A Gallo
Aug 8, 2015·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Alexander J TauchenDouglas Evans
Dec 12, 2012·Acta Anaesthesiologica Scandinavica
May 21, 2014·Journal of Clinical Monitoring and Computing·Jan BenesEduard Kasal
Apr 23, 2013·Clinical Orthopaedics and Related Research·Dane SalazarGuido Marra
Aug 14, 2019·Journal of Shoulder and Elbow Surgery·Justin H ChanGuido Marra
Jun 16, 2021·Clinical Orthopaedics and Related Research·Chanon ThanaboriboonPongkwan Jinaworn

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