Avoiding catastrophic complications of stroke and death related to shoulder surgery in the sitting position.
The beach-chair position in shoulder surgery provides advantages to the surgeon and anesthesiologist. However, cautious interpretation of the patient's blood pressure is essential, especially when the blood pressure cuff is placed at the calf. The calf pressure should be interpreted relative to the heart-level pressure to avoid iatrogenic cerebral hypoperfusion related to hypotensive anesthesia. Possible complications of cerebral hypoperfusion are permanent neurologic impairment, stroke, and death.
Papadonikolakis
Anastasios
A
Department of Orthopaedic Surgery, Wake Forest University Medical Center, Winston-Salem, North Carolina 27157-1070, USA.
Wiesler
Ethan R
ER
Olympio
Michael A
MA
Poehling
Gary G
GG
D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001795:Blood Pressure Determination; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D011187:Posture; D012680:Sensitivity and Specificity; D012782:Shoulder / Q000601:surgery*; D000070599:Shoulder Injuries; D020521:Stroke / Q000517:prevention & control*