title: Effects of positive end-expiratory pressure on arthroscopic shoulder surgery under general anesthesia.
abstract: OBJECTIVE
  Our study is a prospective, randomized study on patients undergoing arthroscopic shoulder surgery in the beach-chair position to evaluate the effects of positive end-expiratory pressure (PEEP) on hemodynamic stability, providing a bloodless surgical field and surgical satisfaction.
  
  
  METHODS
  Fifty patients were divided into two groups. Group I (n=25) had zero end-expiratory pressure (ZEEP) administered under general anesthesia, and group II (n=25) had +5 PEEP administered. During surgery, intraarticular hemorrhage and surgical satisfaction were evaluated on a scale of 0-10. During surgery, at the 5th, 30th, 60th, and 90th minutes and at the end of surgery, heart rate, mean arterial pressure (MAP), and positive inspiratory pressure were recorded. At the end of the surgery, the amount of bleeding and duration of the operation were recorded.
  
  
  RESULTS
  In group I, the duration of operation and amount of bleeding were found to be significantly greater than those in group II (p<0.05). The surgical satisfaction score and clarity of the surgical field were found to be significantly lower in group I than in group II (p<0.05). MAP values in group I were significantly lower than those in group II. The SPO² values in group I were significantly lower than those in group II.
  
  
  CONCLUSIONS
  Adding PEEP to the ventilation parameters of arthroscopic shoulder surgery in the beach-chair position reduces the amount of hemorrhage in the surgical field and thus increases surgical satisfaction without requiring the creation of controlled hypotension.
authors: Okmeydanı Training and Research Hospital, Department of Anaesthesiology and Reanimation, İstanbul, Turkey. drersoy71@hotmail.com.
authors: Ayşın
authors: A
authors: Ersoy
authors: Okmeydanı Training and Research Hospital, Department of Anaesthesiology and Reanimation, İstanbul, Turkey.
authors: Mensure
authors: M
authors: Çakırgöz
authors: Okmeydanı Training and Research Hospital, Department of Anaesthesiology and Reanimation, İstanbul, Turkey.
authors: Zekeriya
authors: Z
authors: Ervatan
authors: Okmeydanı Training and Research Hospital, Department of Anaesthesiology and Reanimation, İstanbul, Turkey.
authors: Özlem
authors: Ö
authors: Kıran
authors: Okmeydanı Training and Research Hospital, Department of Anaesthesiology and Reanimation, İstanbul, Turkey.
authors: Aygen
authors: A
authors: Türkmen
authors: Okmeydanı Training and Research Hospital, Department of Orthopaedic Surgery, İstanbul, Turkey.
authors: Cem Zeki
authors: CZ
authors: Esenyel
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D061646:Operative Time; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods; D000070599:Shoulder Injuries / Q000601:surgery*; D016896:Treatment Outcome; D014421:Turkey