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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
Author(s) -
Fischer Gregory W.,
Torrillo Toni M.,
Weiner Menachem M.,
Rosenblatt Meg A.
Publication year - 2009
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2009.00282.x
Subject(s) - medicine , anesthesia , cerebral perfusion pressure , prone position , cerebral ischaemia , cuff , perfusion , oxygen saturation , surgery , rotator cuff , body position , cerebral blood flow , ischemia , cardiology , oxygen , chemistry , organic chemistry , physical medicine and rehabilitation
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.