Acta Ortopédica Mexicana

Mejía-Terrazas GE, Muñoz-García AJ, Aguirre-Rodríguez VH, Mondragón-Rodríguez AT, López-Muñoz R, Valero-González FS
Total shoulder arthroplasty under monitoring of cerebral perfusion. Report of the first case in Mexico
Acta Ortop Mex 2017; 31 (6)

Language: Español
References: 12
Page: 300-303
PDF: 199.43 Kb.

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ABSTRACT

Introduction: The maintenance of cerebral perfusion during shoulder surgery performed in the beach chair position is controversial. The aim of this report is to present the first case in Mexico of a total shoulder arthroplasty performed with interscalene block and monitoring of the cerebral oxygen saturation. This monitoring was described in 1977, but only until the last decade has it reached relevance from the clinical point of view. Clinical case: We present an 84-year-old patient scheduled for total shoulder arthroplasty in beach chair position under regional anesthesia (ultrasound-guided interscalene block) in which the regional oxygen saturation (CrSO2) was monitored. Discussion: Monitoring of cerebral oximetry is a suitable tool that allows us to have a continuous assessment throughout the transanesthetic, so we can make decisions more expeditiously. On this basis, we believe that this type of monitoring should be fundamental in patients placed in a beach chair position, as well as predominantly use regional anesthesia. In cases where it cannot be used, this monitor is absolutely essential.


Key words: Interscalene block, regional anesthesia, regional oxygen saturation, total shoulder arthroplasty.