<abstract xmlns="http://www.w3.org/1999/xhtml">

Degenerative joint diseases affect the elderly population, and advanced orthopaedic surgery offers novel solutions. The semi-sitting position is used during shoulder replacement surgery. There have been reports of transient and permanent neurological damage following surgery. We aimed to determine cerebral desaturation events (CDEs) during shoulder replacement surgery under general anaesthesia. This prospective, observational study was conducted at the Hospital of Traumatology and Orthopaedics. A cohort of 24 patients received combined plexus brachialis block and endotracheal anaesthesia. Their cerebral regional oxygen saturation index (rSO2) and mean arterial blood pressure (MAP) were recorded and compared in predefined intervals: before induction, post-induction, after getting in a sitting position, after cementing, and after extubation. Hypotension was defined as the occurrence of any of the following: either a > 30% decline in MAP from the baseline or a MAP &lt; 65 mmHg. CDEs were defined as a 20% reduction in frontal lobe oxygenation. Calculations were made using SPSS software (Version 14.0.2, SPSS Inc.). There was a significant correlation between MAP and rSO2 after positioning, between MAP after intubation and rSO2., and between MAP before intubation and rSO2 at the end of surgery. One in three patients who experienced hypotension also experienced a CDE. rSO2 fluctuations correlated with MAP.
</abstract>

Degenerative joint diseases affect the elderly population, and advanced orthopaedic surgery offers novel solutions. The semi-sitting position is used during shoulder replacement surgery. There have been reports of transient and permanent neurological damage following surgery. We aimed to determine cerebral desaturation events (CDEs) during shoulder replacement surgery under general anaesthesia. This prospective, observational study was conducted at the Hospital of Traumatology and Orthopaedics. A cohort of 24 patients received combined plexus brachialis block and endotracheal anaesthesia. Their cerebral regional oxygen saturation index (rSO2) and mean arterial blood pressure (MAP) were recorded and compared in predefined intervals: before induction, post-induction, after getting in a sitting position, after cementing, and after extubation. Hypotension was defined as the occurrence of any of the following: either a > 30% decline in MAP from the baseline or a MAP < 65 mmHg. CDEs were defined as a 20% reduction in frontal lobe oxygenation. Calculations were made using SPSS software (Version 14.0.2, SPSS Inc.). There was a significant correlation between MAP and rSO2 after positioning, between MAP after intubation and rSO2., and between MAP before intubation and rSO2 at the end of surgery. One in three patients who experienced hypotension also experienced a CDE. rSO2 fluctuations correlated with MAP.

Changes in Cerebral Oximetry in Patients Undergoing Shoulder Replacement Surgery

Pauls Stradiņš Clinical University Hospital

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Changes in Cerebral Oximetry in Patients Undergoing Shoulder Replacement Surgery"}

Degenerative joint diseases affect the elderly population, and advanced orthopaedic surgery offers novel solutions. The semi-sitting position is used during...

Changes in Cerebral Oximetry in Patients Undergoing Shoulder Replacement Surgery

Publié en ligne: 23 juil. 2022

Pages: 352 - 356

Reçu: 15 nov. 2021

Accepté: 14 juin 2022

DOI: https://doi.org/10.2478/prolas-2022-0053

Mots clés
NIRS, shoulder arthroplasty, semi-sitting position

© 2022 Dāvis Mackēvičs et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Changes in Cerebral Oximetry in Patients Undergoing Shoulder Replacement Surgery

Publié en ligne: 23 juil. 2022

Pages: 352 - 356

Reçu: 15 nov. 2021

Accepté: 14 juin 2022

DOI: https://doi.org/10.2478/prolas-2022-0053

Mots clésNIRS, shoulder arthroplasty, semi-sitting position

© 2022 Dāvis Mackēvičs et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
NIRS, shoulder arthroplasty, semi-sitting position