A beach chair, comfortably positioned atop an iceberg

摘要

From before the time Rosomoff first used the term "Neuroanesthesia/'1 anesthesiologists have referenced blood pressure (BP) to the level of the circle of Willis (CoW) (typically using the external auditory meatus as the landmark) during procedures performed in the sitting position. That is the way it has always been done in Room 7, the "Neuro Room/' at University of California San Diego Medical Center. Hence, my surprise when, some years ago, I discovered that in an adjacent operating room, BP during orthopedic procedures performed in the beach chair position (BCP) was being calmly managed on the basis of BP measured at the level of the heart, or sometimes the level of the calf. Had the laws of physics changed somewhere in the hallway between Room 7 and Room 6?