Document Detail

Cerebral oxygenation in the beach chair position before and during general anesthesia.
MedLine Citation:
PMID:  20613688     Owner:  NLM     Status:  MEDLINE    
AIM: Ischemic brain damage related to the beach chair position is a matter of concern. The current study was designed to evaluate whether the beach chair position before and during general anesthesia differentially induces changes in cerebral oxygenation as determined by near-infrared spectroscopy (NIRS) in surgical patients.
METHODS: We evaluated brain tissue oxygen index (TOI) values using the NIRS monitor NIRO-200TM in the beach chair position the day before and during general anesthesia. Thirty patients with normal preoperative TOI values undergoing shoulder surgery were enrolled. The initial TOI measurement in the supine position after 10 min rest or 10 min after tracheal intubation was followed by measurements after 5 min each in the 30-degree and subsequently 60-degree head-up tilt positions. During general anesthesia, patients were mechanically ventilated to obtain normocapnia under inhalation of 1.5% sevoflurane in 50% oxygen. Mean blood pressure (MAP) was measured non-invasively in the arm at heart level and was maintained above 60 mmHg with phenylephrine.
RESULTS: Preoperative TOI values and preoperative MAP were within the normal range in the study population. MAP decreased upon anesthesia but did not further change when the patient was placed in the 30- and 60-degree head-up tilt positions. Heart rate also decreased upon anesthesia. However, TOI values did not change with induction of general anesthesia or placement of the patients in the beach chair position.
CONCLUSION: Under general anesthesia, the beach chair position does not alter cerebral oxygenation in patients showing normal preoperative cerebral TOI values.
K Tange; H Kinoshita; T Minonishi; N Hatakeyama; N Matsuda; M Yamazaki; Y Hatano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva anestesiologica     Volume:  76     ISSN:  1827-1596     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  485-90     Citation Subset:  IM    
Department of Anesthesiology, Wakayama Medical University, Wakayama, Wakayama 641-0012, Japan.
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MeSH Terms
Anesthesia, General*
Brain / metabolism*
Middle Aged
Oxygen / metabolism*
Patient Positioning*
Reg. No./Substance:

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