Dataset Information

Fluid preloading before beach chair positioning for arthroscopic shoulder procedures: a randomized controlled trial.

ABSTRACT:

Background and objectives

The Beach Chair Position (BCP) has many advantages such as less neurovascular injury and better intra-articular visualization, but it has also negative consequences, including hemodynamic instability. Although maintaining normal Mean Arterial Pressure (MAP) is important, fluid management is also a crucial concept for hemodynamic stability. The main objective of this study is whether preloading before positioning would be effective for less hemodynamic instability.

Methods

This randomized, controlled study was conducted in a single center in the Istanbul University, Istanbul Faculty of Medicine. Forty-nine patients undergoing elective arthroscopic surgery in the BCP were recruited. In the study group, crystalloid fluid at 10...mL.kg^-1 of ideal body weight was administered intravenously 30...min before the BCP for preloading. The primary outcome measures were differences of hemodynamic variables as MAP, Stroke Volume (SV), Heart Rate (HR), and Cardiac Output (CO). The secondary outcome measures were Postoperative Nausea and Vomiting (PONV) rates in postoperative first day, surgical satisfaction scale, total ephedrine dose used during surgery, and total amount of fluid.

Results

The MAP, CO, and SV measurements of the study group were higher than those of the control group in the 5th minute after the BCP (respectively, p...=...0.001, p...=...0.016, p...=...0.01). The total amount of crystalloid and surgical satisfaction scales were higher in the study group (respectively, p...=...0.016, p...=...0.001). Total amount of colloid and ephedrine dose used in the intraoperative period, and PONV rates were lower in the study group (p...=...0.003, p...=...0.018, p...=...0.019, respectively).

Conclusion

Consequently, preloading can be favorable approach to preserve hemodynamic stability.

SUBMITTER: Gokduman HC

PROVIDER: S-EPMC9660009 | biostudies-literature | 2022 Nov-Dec

REPOSITORIES: biostudies-literature

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Publications

Fluid preloading before beach chair positioning for arthroscopic shoulder procedures: a randomized controlled trial.

Gokduman Huru Ceren HC Aygun Elif E Canbolat Nur N Canbaz Mert M Abdullah Taner T Ersen Ali A Buget Mehmet I MI

Brazilian journal of anesthesiology (Elsevier) 20210923 6

<h4>Background and objectives</h4>The Beach Chair Position (BCP) has many advantages such as less neurovascular injury and better intra-articular visualization, but it has also negative consequences, including hemodynamic instability. Although maintaining normal Mean Arterial Pressure (MAP) is important, fluid management is also a crucial concept for hemodynamic stability. The main objective of this study is whether preloading before positioning would be effective for less hemodynamic instabilit ...[more]

PMID: 34563558

Similar Datasets

Project description:PurposeTo assess the incidence of adverse cerebrovascular events following shoulder arthroscopy in the beach-chair position when compared with the lateral position.MethodsRecords of 5 shoulder surgeons were searched using Current Procedural Technology codes to identify patients who underwent arthroscopic shoulder surgery in both the beach-chair and lateral positions between 2015 and 2020. Using both Current Procedural Technology codes for cerebrovascular accident (CVA) imaging as well as the International Classification of Diseases, Tenth Revision, codes for CVA and late neurologic sequela, patient charts were analyzed in the 30-day postoperative period. The anesthesiology record also was queried for data regarding the blood pressure management intraoperatively, recording mean arterial pressures (MAPs), and vasopressor administration. Patient demographics, comorbidities, and complications were compared between the 2 cohorts using the Student 2-tailed t-test for continuous variables and χ2 analysis for categorical variables. Significance was set at P < .05.ResultsThere were 711 patients included in the analysis, with 471 in the beach-chair cohort and 240 in the lateral cohort. Baseline demographics were similar between groups, except for age and American Society of Anesthesiologists physical status classification, with the lateral group being significantly younger (P < .001) and lower American Society of Anesthesiologists physical status classification (P = .001) than the beach-chair group. Mean body mass index, history of CVA, transient ischemic attack, hypertension, and peripheral vascular disease were not significantly different. There were no documented CVAs in either cohort. There was no significant difference in the number of postoperative radiologic scans to evaluate for CVA (P = .77) or neurologic sequelae (P = .48) between groups. The beach-chair cohort had fewer instances of MAP <65 mm Hg, greater mean minimum MAP, but a greater percentage of patients who received blood pressure support.ConclusionsThere were no significant differences identified in the incidence of CVA between patients undergoing arthroscopic shoulder surgery in the beach-chair and lateral positions.Level of evidenceLevel III, retrospective cohort study.

Dataset Information

Fluid preloading before beach chair positioning for arthroscopic shoulder procedures: a randomized controlled trial.

Background and objectives

Methods

Results

Conclusion

Publications

Fluid preloading before beach chair positioning for arthroscopic shoulder procedures: a randomized controlled trial.

Similar Datasets

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