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Severe cerebral desaturation during shoulder arthroscopy in the beach-chair position

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  • Christian Dippmann
  • Søren Winge
  • Henning Bay Nielsen
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.
OriginalsprogEngelsk
TidsskriftArthroscopy: The Journal of Arthroscopy and Related Surgery
Vol/bind26
Udgave nummer9 Suppl
Sider (fra-til)S148-50
ISSN0749-8063
DOI
StatusUdgivet - 1 sep. 2010

ID: 34164382