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https://www.readbyqxmd.com/read/27909677/basic-shoulder-arthroscopy-lateral-decubitus-patient-positioning
#1
Alexander H Jinnah, Sandeep Mannava, Johannes F Plate, Austin V Stone, Michael T Freehill
Shoulder arthroscopy offers a minimally invasive surgical approach to treat a variety of shoulder pathologies. The patient can be positioned in either the lateral decubitus or the beach chair position. This note and accompanying video describe the operating room setup for shoulder arthroscopy in the lateral decubitus position, including positioning of the arms, head, and sterile preparation and draping. Appropriate lateral decubitus positioning for shoulder arthroscopy with careful attention to detail will promote ease of surgical intervention and minimize complications...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909672/arthroscopic-360%C3%A2-capsular-release-for-adhesive-capsulitis-in-the-lateral-decubitus-position
#2
Gregory L Cvetanovich, Timothy Leroux, Jason T Hamamoto, John D Higgins, Anthony A Romeo, Nikhil N Verma
Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904212/functional-outcome-after-primary-hemiarthroplasty-in-three-or-four-part-proximal-humerus-fracture-a-short-term-followup
#3
Saurabh Agarwal, Ashish Rana, Rajeev K Sharma
BACKGROUND: Several modalities of treatment are being used for the management of proximal humerus fractures. Primary hemiarthroplasty in proximal humerus fracture is indicated in three or four part fracture or fracture dislocations. It is also indicated if fracture involves a large area of articular cartilage loss and viability of head is doubtful. We studied the functional outcome of hemiarthroplasty in comminuted proximal humerus fracture. MATERIALS AND METHODS: 29 patients of three or four part proximal humerus fractures, (according to Neer's classification) who underwent primary shoulder hemiarthroplasty were included in this retrospective study...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27871574/cerebral-oxygenation-in-the-beach-chair-position-for-shoulder-surgery-in-regional-anesthesia-impact-on-cerebral-blood-flow-and-neurobehavioral-outcome
#4
José A Aguirre, Olivia Märzendorfer, Muriel Brada, Andrea Saporito, Alain Borgeat, Philipp Bühler
STUDY OBJECTIVE: Beach chair position is considered a potential risk factor for central neurological events particularly if combined with low blood pressure. The aim of this study was to assess the impact of regional anesthesia on cerebral blood flow and neurobehavioral outcome. DESIGN: This is a prospective, assessor-blinded observational study evaluating patients in the beach chair position undergoing shoulder surgery under regional anesthesia. SETTING: University hospital operating room...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27796526/hemodynamic-monitoring-during-surgeries-in-beach-chair-position-what-can-a-big-picture-teach-us
#5
EDITORIAL
Markus M Luedi, Karim Bendjelid
No abstract text is available yet for this article.
October 31, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27738950/patterns-of-intra-arterial-blood-pressure-monitoring-for-patients-undergoing-total-shoulder-arthroplasty-under-general-anesthesia-a-retrospective-analysis-of-23-073-patients
#6
Rodney A Gabriel, Anair Beverly, Richard P Dutton, Richard D Urman
Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on clinical judgment. We aimed to describe patient, surgical and institutional factors associated with the current use of blood pressure monitoring via an arterial line for TSA. We used de-identified patient data from the National Anesthesia Clinical Outcomes Registry between 2010 and 2015 to identify patients undergoing TSA under general anesthesia...
October 13, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27709029/basic-shoulder-arthroscopy-beach-chair-patient-positioning
#7
Sandeep Mannava, Alexander H Jinnah, Johannes F Plate, Austin V Stone, Christopher J Tuohy, Michael T Freehill
Shoulder arthroscopy is an orthopaedic procedure that has grown significantly in popularity over the last 40 years. The 2 principle patient positions during shoulder arthroscopy include the beach chair position and lateral decubitus position. This Technical Note details the operating room setup for shoulder arthroscopy in the beach chair position. Proper positioning for this procedure will minimize potential complications and facilitate ease of surgical intervention.
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27687453/delayed-onset-and-long-lasting-hemidiaphragmatic-paralysis-and-cranial-nerve-deficit-after-interscalene-nerve-block-for-rotator-cuff-repair-in-beach-chair-position
#8
Chukwudi O Chiaghana, Caleb A Awoniyi
Hemidiaphragmatic paralysis is the most common adverse effect associated with interscalene block. In most cases, it resolves with the resolution of nerve blockade with only an estimated incidence of 0.048% persisting for longer duration. Occasionally, interscalene block is also associated with recurrent laryngeal nerve block and seldom with cranial nerve paresis. We present a case of delayed onset and prolonged hemidiaphragmatic paralysis that was associated with 3 cranial nerve deficits after interscalene nerve block for shoulder surgery performed under general anesthesia in the beach chair position...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27591460/patient-state-index-and-cerebral-blood-flow-changes-during-shoulder-arthroscopy-in-beach-chair-position
#9
Mehmet Ilke Buget, Ata Can Atalar, Ipek Saadet Edipoglu, Zerrin Sungur, Nukhet Sivrikoz, Meltem Karadeniz, Esra Saka, Suleyman Kucukay, Mert N Senturk
BACKGROUND AND OBJECTIVES: The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. METHODS: 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0)...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27560643/traction-injury-of-the-brachial-plexus-confused-with-nerve-injury-due-to-interscalene-brachial-block-a-case-report
#10
Francisco Ferrero-Manzanal, Raquel Lax-Pérez, Roberto López-Bernabé, José Ramiro Betancourt-Bastidas, Alvaro Iñiguez de Onzoño-Pérez
INTRODUCTION: Shoulder surgery is often performed with the patient in the so called "beach-chair position" with elevation of the upper part of the body. The anesthetic procedure can be general anesthesia and/or regional block, usually interscalenic brachial plexus block. We present a case of brachial plexus palsy with a possible mechanism of traction based on the electromyographic and clinical findings, although a possible contribution of nerve block cannot be excluded. PRESENTATION OF THE CASE: We present a case of a 62 year-old female, that suffered from shoulder fracture-dislocation...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27555129/middle-cerebral-artery-blood-flow-velocity-during-beach-chair-position-for-shoulder-surgery-under-general-anesthesia
#11
Jean-Luc Hanouz, Anne-Lise Fiant, Jean-Louis Gérard
OBJECTIVES: The goal of the present study was to examine changes of middle cerebral artery (VMCA) blood flow velocity in patients scheduled for shoulder surgery in beach chair position. DESIGN: Prospective observational study. SETTING: Operating room, shoulder surgery. PATIENTS: Fifty-three consecutive patients scheduled for shoulder surgery in beach chair position. INTERVENTIONS: Transcranial Doppler performed after induction of general anesthesia (baseline), after beach chair positioning (BC1), during surgery 20minutes (BC2), and after back to supine position before stopping anesthesia (supine)...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27432526/-patient-state-index-and-cerebral-blood-flow-changes-during-shoulder-arthroscopy-in-beach-chair-position
#12
Mehmet Ilke Buget, Ata Can Atalar, Ipek Saadet Edipoglu, Zerrin Sungur, Nukhet Sivrikoz, Meltem Karadeniz, Esra Saka, Suleyman Kucukay, Mert N Senturk
BACKGROUND AND OBJECTIVES: The aim of the study were to demonstrate the possible hemodynamic changes and cerebral blood flow alterations in patients who were positioned from supine to beach chair position; and to detect if the position change causes any cortical activity alteration as measured by the 4-channeled electroencephalography monitor. METHODS: 35 patients were included. Before the induction, mean arterial pressure and patient state index values were recorded (T0)...
September 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27382327/ketofol-for-monitored-anesthesia-care-in-shoulder-arthroscopy-and-labral-repair-a-case-report
#13
Kevin C Lee, Hanyuan Shi, Brian C Lee
A 21-year-old male (body mass index: 28.3) with a history of asthma and reactive airway disease since childhood underwent left shoulder arthroscopy and labral repair surgery under monitored anesthesia care. Because the procedure was performed in the beach chair position, access to the patient's airway was limited throughout. To avoid general anesthesia and to limit potential complications associated with monitored anesthesia care, a ketofol admixture was used. This case demonstrates that, in conjunction with regional anesthesia, ketofol may be an acceptable alternative to propofol for maintenance in outpatient orthopedic procedures...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27299449/effect-of-patient-positioning-in-axillary-nerve-safety-during-arthroscopic-inferior-glenohumeral-ligament-plication
#14
Adrián Cuéllar, Ricardo Cuéllar, Jorge Díaz Heredia, Asier Cuéllar, Miguel Angel Ruiz-Ibán
PURPOSE: To evaluate the risk of injuring the axillary nerve during an inferior glenohumeral ligament (IGHL) plication and finding out whether shoulder position (either beach chair position or lateral decubitus position) has any effect in this risk. METHODS: The axillary nerve (AN) was identified through a 3-cm posterior incision in 12 cadaveric shoulders. Under arthroscopic visualization, a curved indirect suture-passing device was placed through the posterior and anterior bands of the IGHL...
June 14, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27218200/pneumothorax-following-shoulder-arthroscopy-under-combined-regional-and-general-anaesthesia-a-case-report
#15
Oskar Leander-Olsson, Anna Borglund-Hemph, Jan G Jakobsson
INTRODUCTION: Pneumothorax is a most rare intraoperative event but jeopardise safety. Risk factors for its occurrence should be acknowledged and it should be considered in cases of unexpected deterioration of oxygenation that not respond to standard management to improve oxygenation. PRESENTATION OF CASE: We describe a patient with mild obesity and recent shoulder trauma scheduled for elective arthroscopy under combined interscalene block and general anaesthesia in the beach chair position...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27163102/comparison-of-accuracy-of-anterior-and-superomedial-approaches-to-shoulder-injection-an-experimental-study
#16
Bancha Chernchujit, Nutthapon Zonthichai
INTRODUCTION: We aimed to compare the accuracy between the standard anterior technique of shoulder injection and the new superomedial technique modified from Neviaser arthroscopic portal placement. Intra-articular placement, especially at the long head of biceps (LHB) tendon, and needle depth were evaluated. METHODS: Fifty-eight patients (ages 57 ± 10 years) requiring shoulder arthroscopy in the beach-chair position were recruited. Needle punctures for both techniques were performed by an experienced sports medicine orthopedist...
2016: SICOT-J
https://www.readbyqxmd.com/read/27049715/prevention-of-ventilator-associated-pneumonia-in-the-intensive-care-unit-beyond-the-basics
#17
Vickie Larrow, Eira I Klich-Heartt
Ventilated-associated pneumonia (VAP) is a major concern for hospitals and a major problem for ventilated patients in the intensive care unit. Included in the basics are hand hygiene, wearing gloves, endotracheal tube suctioning, head of bed at 30°, stress ulcer prophylaxis, turning patient side to side at least every two hours, and giving the patient a sedation vacation each morning. Beyond the basics included here are oral hygiene, oral suctioning, endotracheal tube cuff pressure, artificial humidification, the difference in practice between registered nurses and respiratory therapists, using the beach chair position and early mobilization, and the VAP bundle...
June 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/27017773/-anesthetic-management-for-a-patient-with-stiff-person-syndrome
#18
Kumiko Nakamura, Kohei Murao, Michiyo Kimoto-Shirakawa, Kazuyo Takahira, Farah Toorabally, Koh Shingu
The stiff-person syndrome (SPS) is a rare autoimmune neurologic disorder that affects the gamma-aminobutyric acid (GABA) mediated inhibitory network in the central nervous system with anti-glutamic acid decarboxylase (GAD) antibodies. SPS is characterized by muscle rigidity and painful episodic spasms in axial and lower limb muscles. This case report describes successful peri-operative management of a 61-year-old female (height, 158 cm; weight, 60 kg, ASA-PS 2) with her right upper arm fracture who was scheduled for open reduction and internal fixation...
February 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26991585/neurocognitive-deficits-and-cerebral-desaturation-during-shoulder-arthroscopy-with-patient-in-beach-chair-position-a-review-of-the-current-literature
#19
REVIEW
Dane Salazar, Antony Hazel, Alexander J Tauchen, Benjamin W Sears, Guido Marra
Arthroscopic shoulder surgery with the patient in the beach-chair position (BCP) has been associated with neurocognitive complications caused by cerebral ischemia. We reviewed the current literature for the incidence of postoperative neurocognitive deficits, number of reported neurocognitive complications, and incidence of intraoperative cerebral desaturation events in patients who underwent arthroscopic shoulder surgery in the BCP. Among 10 studies with a composite enrollment of 24,701 patients, there was only 1 case of a postoperative neurocognitive deficit (overall incidence, 0...
March 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/26889473/postoperative-pectoral-swelling-after-shoulder-arthroscopy
#20
Ersin Ercin, Mustafa Gokhan Bilgili, Halil Nadir Ones, Cemal Kural
Fluid extravasation is possibly the most common complication of shoulder arthroscopy. Shoulder arthroscopy can lead to major increases in the compartment pressure of adjacent muscles and this phenomenon is significant when an infusion pump is used. This article describes a case of pectoral swelling due to fluid extravasation after shoulder arthroscopy. A 24-year-old male underwent an arthroscopic Bankart repair for recurrent shoulder dislocation. The surgery was performed in the beach chair position and lasted two hours...
July 2015: Joints
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