Patient Diversity Is Our Reality: the Covariates Matter

Excerpt

It is my pleasure to bring you the latest issue of HSS Journal®. This issue presents several articles on the hand and upper extremity, one in particular that should catch the interest of shoulder surgeons. For reconstructive surgery on the shoulder, general anesthesia is often required, and patients are often placed in the beach chair position. Many anesthesiologists have suggested that general anesthesia applied in this position increases risk of cerebral oxygen desaturation. In “Cerebral Oxygenation in the Sitting Position Is Not Compromised During Spontaneous or Positive-Pressure Ventilation” (https://​doi.​org/​10.​1007/​s11420-018-9642-4), Ya Deau and his colleagues investigated the cerebral blood oxygenation of 25 patients undergoing total shoulder arthroplasty using general anesthesia in the beach chair position. This prospective, observational study found no cerebral desaturation events in this cohort, providing supportive evidence to the greater anesthesia community that cerebral oxygenation and perfusion can be safely maintained in the beach chair position. …