title: The Effect of Compression Stockings on Cerebral Desaturation Events in Obese Patients Undergoing Shoulder Arthroscopy in the Beach-Chair Position.
abstract: OBJECTIVE
  To determine if the use of thigh-high compression stockings could decrease the incidence of cerebral desaturation events (CDEs) in patients with a body mass index (BMI) of 30 kg/m(2) or greater undergoing shoulder arthroscopy in the beach-chair position (BCP).
  
  
  METHODS
  Between December 2013 and May 2014, 23 patients aged 18 years or older with a BMI of 30 kg/m(2) or greater undergoing shoulder arthroscopy in the BCP were monitored intraoperatively using near-infrared spectroscopy while wearing thigh-high compression stockings. Data obtained on these patients were compared with data from a previous cohort at our institution comprising 24 patients with a BMI of 30 kg/m(2) or greater who underwent elective shoulder arthroscopy in the BCP with the same monitoring but without wearing compression stockings. The incidence of CDEs was identified in each group.
  
  
  RESULTS
  The incidence of CDEs in the group with compression stockings was 4% (1 of 23) compared with 18% (7 of 24) in the group without compression stockings (P = .048). There were no statistically significant differences in mean age (53.0 years v 53.3 years, P = .91), mean BMI (34.5 kg/m(2)v 36.2 kg/m(2), P = .21), or various medical comorbidities between the treatment group and control group. There was a significant difference in the operative time between the treatment group (156.6 minutes) and control group (94.1 minutes) (P < .001).
  
  
  CONCLUSIONS
  The use of thigh-high compression stockings may decrease the incidence of CDEs in obese patients undergoing shoulder arthroscopy in the BCP.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois, U.S.A.. Electronic address: atauchen@lumc.edu.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Tauchen
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois, U.S.A.
authors.forename: Dane
authors.initials: D
authors.lastname: Salazar
authors.affiliation: Loyola University Stritch School of Medicine, Maywood, Illinois, U.S.A.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Barton
authors.affiliation: Department of Anesthesia, Loyola University Medical Center, Maywood, Illinois, U.S.A.
authors.forename: Audrice
authors.initials: A
authors.lastname: Francois
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois, U.S.A.
authors.forename: Pietro
authors.initials: P
authors.lastname: Tonino
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois, U.S.A.
authors.forename: Nickolas G
authors.initials: NG
authors.lastname: Garbis
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, Illinois, U.S.A.
authors.forename: Douglas
authors.initials: D
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology / Q000517:prevention & control*; D007592:Joint Diseases / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010100:Oxygen / Q000032:analysis; D056888:Patient Positioning / Q000009:adverse effects; D011187:Posture / Q000502:physiology*; D011446:Prospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D019265:Spectroscopy, Near-Infrared; D053828:Stockings, Compression
chemical_list: D010100:Oxygen