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Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination
There have been devastating reports of patients suffering permanent neurological damage following surgery in the beach chair position. Recent literature have shown that placing a patient under general anaesthesia in the beach chair position may place patients at risk of complications. There is no se...
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| Format: | Thesis |
| Language: | English |
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Department of Health and Rehabilitation Sciences
2016
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| _version_ | 1867613225345875968 |
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| access_status_str | Open Access |
| author | Naude, Petrus Hendrik |
| author2 | Roche, Stephen J |
| author_browse | Naude, Petrus Hendrik Roche, Stephen J |
| author_facet | Roche, Stephen J Naude, Petrus Hendrik |
| author_sort | Naude, Petrus Hendrik |
| collection | Thesis |
| description | There have been devastating reports of patients suffering permanent neurological damage following surgery in the beach chair position. Recent literature have shown that placing a patient under general anaesthesia in the beach chair position may place patients at risk of complications. There is no set angle of inclination used by all orthopaedic surgeons. Previous research have used angles of 70˚-90˚. At these angles patients suffered a significant number of cerebral desaturation events that may lead to ischaemic neurological events. This angle is far more upright than what is used in our practice. We postulated that decreasing the angle of inclination may be protective of cerebral perfusion. We performed a prospective randomised single blind study. 45 consecutive patients presenting for shoulder surgery were randomised to 2 groups. The control group patients were placed in the normal position used by the surgeon for the procedure and this angle was measured. The patients in the trial group were all placed at 30˚. Patients with known cerebrovascular disease, younger than 18 years, ASA grade 4 and 5, allergy to local anaesthetic, pre-existing coagulopathies or a failed interscalene block were excluded. Cerebral oxygenation were measured with the INVOS system along with the other standard observations in theatre. The 2 most important parameters measured were mean arterial pressure and cerebral oxygenation levels. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/20785 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:45.765Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2016 |
| publishDateRange | 2016 |
| publishDateSort | 2016 |
| publisher | Department of Health and Rehabilitation Sciences |
| publisherStr | Department of Health and Rehabilitation Sciences |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/20785 Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination Naude, Petrus Hendrik Roche, Stephen J Orthopaedic Surgery There have been devastating reports of patients suffering permanent neurological damage following surgery in the beach chair position. Recent literature have shown that placing a patient under general anaesthesia in the beach chair position may place patients at risk of complications. There is no set angle of inclination used by all orthopaedic surgeons. Previous research have used angles of 70˚-90˚. At these angles patients suffered a significant number of cerebral desaturation events that may lead to ischaemic neurological events. This angle is far more upright than what is used in our practice. We postulated that decreasing the angle of inclination may be protective of cerebral perfusion. We performed a prospective randomised single blind study. 45 consecutive patients presenting for shoulder surgery were randomised to 2 groups. The control group patients were placed in the normal position used by the surgeon for the procedure and this angle was measured. The patients in the trial group were all placed at 30˚. Patients with known cerebrovascular disease, younger than 18 years, ASA grade 4 and 5, allergy to local anaesthetic, pre-existing coagulopathies or a failed interscalene block were excluded. Cerebral oxygenation were measured with the INVOS system along with the other standard observations in theatre. The 2 most important parameters measured were mean arterial pressure and cerebral oxygenation levels. 2016-07-26T12:19:21Z 2016-07-26T12:19:21Z 2016 Master Thesis Masters MMed http://hdl.handle.net/11427/20785 eng application/pdf Department of Health and Rehabilitation Sciences Faculty of Health Sciences University of Cape Town |
| spellingShingle | Orthopaedic Surgery Naude, Petrus Hendrik Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| thesis_degree_str | Master's |
| title | Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| title_full | Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| title_fullStr | Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| title_full_unstemmed | Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| title_short | Prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| title_sort | prospective study to compare the difference in cerebral perfusion in patients undergoing shoulder surgery with the standard beach chair position compared to 30˚ inclination |
| topic | Orthopaedic Surgery |
| url | http://hdl.handle.net/11427/20785 |
| work_keys_str_mv | AT naudepetrushendrik prospectivestudytocomparethedifferenceincerebralperfusioninpatientsundergoingshouldersurgerywiththestandardbeachchairpositioncomparedto30inclination |