Shoulder Surgery in the Beach Chair Position is Associated with Diminished Cerebral Autoregulation but no Differences in Postoperative Cognition or Brain Injury Biomarker Levels Compared with Supine Positioning: The Anesthesia Patient Safety Foundation Beach Chair Study

摘要

BackgroundAlthough controversial, failing to consider the gravitational effects of head elevation on cerebral perfusion is speculated to increase susceptibility to rare, but devastating, neurologic complications after shoulder surgery in the beach chair position (BCP). We hypothesized that patients in the BCP have diminished cerebral blood flow autoregulation than those who undergo surgery in the lateral decubitus position (LDP). A secondary aim was to examine whether there is a relationship between patient positioning during surgery and postoperative cognition or serum brain injury biomarker levels.