Effect of head and neck positioning on cerebral perfusion during shoulder arthroscopy in beach chair position Journal Article


Authors: Salazar, D; Sears, B.; Acosta, A.; Aghdasi, B.; Francois, A.; Tonino, P; Marra, G
Article Title: Effect of head and neck positioning on cerebral perfusion during shoulder arthroscopy in beach chair position
Abstract: The aim of this prospective cohort study was to investigate the effect of head and neck positioning on cerebral perfusion during shoulder arthroscopy in the beach chair position. Regional cerebral tissue oxygen saturation (rSO2) was monitored intraoperatively using near-infrared spectroscopy on 51 consecutive patients undergoing arthroscopic shoulder surgery in the beach chair position. The head of each subject was manipulated by the examiner and sequentially positioned for 45 seconds in terminal flexion, extension, bilateral rotation, and bilateral lateral bending. Decreases in rSO2 of 20% or greater from baseline were defined as a cerebral desaturation event (CDE). The association between head and neck position and cerebral perfusion was assessed. Eight percent of patients (4/51) experienced CDE during head and neck positioning. Body mass index was found to be a risk factor for CDE (p = .05). When comparing preoperative baseline rSO2 to intraoperative supine and intraoperative upright rSO2, there was no significant decrease in saturation levels for any of the six tested positions. Frequent intraoperative evaluations of the head and neck position as well as careful preoperative positioning may reduce the risk of position-related complications in patients undergoing elective shoulder arthroscopy in the beach chair position. In this study's patient population, however, head and neck position was not found to cause significant cerebral desaturation for the time period tested compared to preoperative baselines.
Journal Title: Journal of surgical orthopaedic advances
Volume: 23
Issue: 2
ISSN: 1548-825X; 1548-825X
Publisher: Unknown  
Journal Place: United States
Date Published: 2014
Start Page: 83
End Page: 89
Language: eng
DOI/URL:
Notes: JID: 101197881; ppublish
LUC Authors
  1. Pietro Tonino
    10 Tonino
  2. Dane Salazar
    32 Salazar
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