The effect of beachchair position on cerebral blood flow during shoulder arthroscopy

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Shoulder arthroscopy, or keyhole surgery of the shoulder, has been an accepted form of surgery for many years. The surgery can be performed with the patient sitting upright (beachchair position), or lying on their side. Both techniques have been performed successfully for many years. The choice is usually dependent on the professional experience and preference of the surgeon. One of the research investigators, typically performs this surgery in the upright position. Some medical professionals are of the opinion that performing shoulder arthroscopy in the upright position, can affect flow of blood to the brain. This is not something that has been conclusively demonstrated by research to date. We use a technique of anaesthesia that we believe is very safe and is used widely throughout the world. Further, we are of the opinion that it does not adversely affect flow of blood to the brain. The surgery will be performed using the anaesthetic technique that we use for the majority of the surgeon’s cases. The patient will receive a nerve block that will anaesthetise the arm receiving surgery. This will be combined with either a general anaesthetic or intravenous sedation. We will use an ultrasound probe to monitor the flow of blood in the major arteries in the patient’s neck. This will give us an indication of the flow of blood to the brain. The increased monitoring will ensure patient safety during the procedure, as we will be able to detect previously unknown side-to-side differences in blood flow in the individual patients. The research will help us prove to others unfamiliar with the technique, that it is safe for this surgery.

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