Key result
Hypotension after anesthesia during shoulder arthroscopy in the beach-chair position provoked a decrease in frontal lobe oxygenation by approximately 40% in two patients.
Case Report (n=2)
Hypotension during shoulder arthroscopy in the beach-chair position can cause severe cerebral desaturation, highlighting the need for cerebral oxygenation monitoring and optimization.
Alerts to cerebral desaturation risk in beach-chair arthroscopy; case report leaves open monitoring utility.
During shoulder arthroscopy in the beach-chair position, cerebral ischemia may be a serious complication because prolonged hypotension may affect regional cerebral oxygen supply. We present the cases of 2 patients in whom a reduction in mean arterial pressure after anesthesia provoked a decrease in frontal lobe oxygenation to below the level that causes presyncopal symptoms in the awake subject. In the healthy middle-aged patient, cerebral oxygenation decreased by approximately 40%, indicating that cerebral blood flow was markedly reduced, and intravenous administration of ephedrine rapidly restored cerebral oxygenation. During surgery in the beach-chair position, hypotension must be avoided, and in all patients regional, cerebral oxygenation should be monitored and optimized.
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Dippmann et al. (2010) conducted a case report in Shoulder arthroscopy in the beach-chair position (n=2). Shoulder arthroscopy in the beach-chair position with hypotension was evaluated on Cerebral oxygenation. Hypotension after anesthesia during shoulder arthroscopy in the beach-chair position provoked a decrease in frontal lobe oxygenation by approximately 40% in two patients.
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