Key result
Cerebral oximetry monitoring detected a decrease in cerebral oxygen saturation during positioning that was treated with phenylephrine, suggesting its potential utility in managing nonsupine patients.
Why the study?
Does cerebral oximetry monitoring help manage cerebral perfusion in patients undergoing surgery in the beach chair position?
Case Report (n=1)
Does cerebral oximetry monitoring help manage cerebral perfusion in patients undergoing surgery in the beach chair position?
Cerebral oximetry may be a useful monitor to guide management of cerebral perfusion in nonsupine surgical patients.
May support cerebral oximetry in beach chair positioning; hypothesis-generating case report requiring prospective validation before practice change.
Four cases of ischemic injury have been reported in patients undergoing orthopedic surgery in the upright position. We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63-year-old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (S(ct)O(2)) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end-tidal carbon dioxide was accompanied by an increase in S(ct)O(2). Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients.
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Fischer et al. (2009) conducted a case report in Orthopedic surgery in the upright position (n=1). Cerebral oximetry monitoring was evaluated on Cerebral oxygen saturation (S(ct)O(2)). Cerebral oximetry monitoring detected a decrease in cerebral oxygen saturation during positioning that was treated with phenylephrine, suggesting its potential utility in managing nonsupine patients.
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