Date of Award

8-2009

Document Type

Independent Study

Degree Name

Master of Science (MS)

Abstract

The complex and dynamic physiological changes that occur when a patient is anesthetized may be further influenced by the surgical positioning of the patient, including that of the beach-chair position. The beach-chair position is often utilized during orthopedic shoulder surgery. The purpose of this review is to identify, utilizing an evidenced-based approach, the potential risks to cerebral and/or spinal cord perfusion when utilizing the beach chair position for surgical procedures under general (and/or regional) anesthesia. Additionally, this review will identify physiological effects on cerebral auto perfusion during anesthesia utilizing the beach-chair position, as well as special considerations or guidelines anesthesia providers should follow when monitoring surgical patients in the beach chair position.

A comprehensive literature review utilizing retrospective reviews, case reviews, prospective studies regarding the beach-chair position and potential complications associated with this position was conducted. A PowerPoint presentation describing the beach-chair position, cerebral auto perfusion, and potential complications associated with this position was developed and presented to Student Registered Nurse Anesthetists at a Midwestern Hospital. This presentation was multi-dimensional with the goal being active participation by the group. Additionally, methodology involved a question/answer session based on relevant patient case scenarios. A post-presentation evaluation tool was used to evaluate the quality of the presentation. The physiological framework of adaption and homeostasis was used as the theoretical basis for this project.

The expected result of this project is to build awareness and knowledge among Certified Registered Nurse Anesthetists regarding the potential for complications when using the beach chair position during anesthesia by providing the current "best evidentiary" research available.

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