Arterial pressure and heart rate changes in patients during "beach chair position" for shoulder surgery: comparison of the regional and general anesthesia techniques

Background and Purpose: Patients scheduled to shoulder surgery are placed in a sitting position called "the beach chair position" during the operation. This type of surgery, can be performed with two anesthetic techniques: general anesthesia or regional anesthesia (interscalene block). This patient positioning is characterized by changes in heart rate and systemic blood pressure. The aim of this study is to show whether the type of anesthetic technique influence the changes in systemic pressure and heart rate in this particular patient position. Materials and Methods: Retrospective clinical study with reviewed anesthetic charts and medical documentation of the patients scheduled for elective shoulder surgery. Point measurements of systolic and diastolic blood pressure and heart rate were: before surgery, after the positioning of the anesthetized patient, at the end of the operation (lodging of the patient) and then the lowest recorded pressure and heart rate during surgery. Results: The study included 66 patients in the sitting position for shoulder surgery. Positioning the patients in the beach chair position for shoulder surgery in a population of patients undergoing general anesthesia in relation to the population of patients treated under regional anesthesia, had a significant effect on the decline in systolic blood pressure (p<0.00I) and dyastolic blood pressure (p=0.008). Conclusion: Regional anesthesia has proven again to be the superior technique over general anesthesia, including cardiovascular stability in patients subjected to shoulder surgery in the beach chair position.