title: The use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a patient undergoing shoulder surgery in the beach chair position.
abstract: 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.
authors.affiliation: Anesthesiology and Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, New York 10029, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Fischer
authors.forename: Toni M
authors.initials: TM
authors.lastname: Torrillo
authors.forename: Menachem M
authors.initials: MM
authors.lastname: Weiner
authors.forename: Meg A
authors.initials: MA
authors.lastname: Rosenblatt
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002536:Cerebral Arteries / Q000294:innervation / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010092:Oximetry / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011187:Posture / Q000502:physiology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity