Beach chair position による肩関節鏡視下手術中の脳血流, 脳波の変化

概要

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The shoulder arthroscopy in the beach chair position (BCP) has become common. The advantages of this position include more physiological position, easier dynamic evaluation, and easier conversion to the open surgery than lateral decubitus position. However this position could be associated with significant hemodynamic changes that may lead to deterioration of cerebral circulation. The purpose of this study was to investigate how BCP affected cerebral circulation and electrical activity. 10 patients (7 males and 3 females) were evaluated. Their ages averaged 49.4years old and ranged from 19 to 74 years old. Blood pressure (BP), heart rate (HR), regional cerebral oxygen saturation (rSO2) and spectral edge frequency 95(SEF95) were measured before and after BCP. Systolic BP decreased from 95 ± 13mmHg before BCP to 73 ± 15mmHg after BCP. Diastlic BP decreased from 44 ± 7mmHg to 33 ± 11mmHg. HR decreased from 59 ± 8bpm to 56 ± 4bpm. rSO2 decreased from 72 ± 11% to 57 ± 12%. SEF95 decreased from 12.3 ± 1.8Hz to 11.2 ± 1.8Hz. BP, rSO2 and SEF95 after BCP demonstrated significant decreases. Although no apparent complication associated with BCP was experienced in this study, this study suggested that BCP had a potential risk of cerebral damage.
日本肩関節学会の論文
2009-07-27