Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


Title: Cerebral Oximetry During Shoulder Surgery in the Beach Chair Position

Background: A non-invasive blood pressure (NIBP) measurement of mean arterial pressure (MAP) has historically been the main parameter for ensuring adequate cerebral perfusion pressure (CPP) vvhen patients are placed in the beach chair position (BCP). Rare but catastrophic neurological injuries have been re ported following the BCP for shoulder surgery, possibly wa!1'anting the use of real-time, site -spec ific monitoring of oxygenation and perfusion at the level of the brain w ith cerebral oximetry

Purpose: The purpose of this report is to determine if the addition of cerebral oximetry monitoring, compared with standard monitoring methods alone, reduces the incidence of neurological complications for patients in the beach chair position perioperatively for shoulder surgery.

Process: A comprehensive review of the literature was completed utilizing the Pub Med database from the Harley E. French Library of the Health Sciences website . The findings were extensively evaluated to determine relevance to the research question .

Results: Standard monitoring methods do not always depict a problem when cerebral oximetry shows a significant decrease, indicating that additional monitoring with cerebral oximetry may be useful for maintaining adequate perfusion to the brain during beach chair positioning. The level of cerebral desaturation that results in neurological deficits is not well understood. There are a number of factors that can increase the risk for intraoperative cerebral desaturation. When cerebral oximetry is utilized, it can be beneficial to have protocols in place to prevent and/or treat cerebral desaturation events, facilitating prompt correction of possible cerebral malperfusion.

lmplications: Cerebral oximetry is a non-invasive, site-specific, and continuous measurement to depict cerebral perfusion that can increase patient safety.

Keywords: cerebral oximetry, near-infrared spectroscopy, shoulder surgery, and beach chair position