СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ ОБЕСПЕЧЕНИЯ БЕЗОПАСНОСТИ ПАЦИЕНТА В ПОЛОЖЕНИИ ШЕЗЛОНГА ПРИ АРТРОСКОПИЧЕСКИХ ОПЕРАЦИЯХ НА ПЛЕЧЕВОМ СУСТАВЕ
Обзорная статья
Дата публикации: июня 16, 2021
Ключевые слова
артроскопия
спектрометрия
операции в положении сидя
спектрометрия
операции в положении сидя
Как цитировать
Крылов С. В., Пасечник И. Н., Орлецкий А. К., Тимченко Д. О. СОВРЕМЕННОЕ СОСТОЯНИЕ ПРОБЛЕМЫ ОБЕСПЕЧЕНИЯ БЕЗОПАСНОСТИ ПАЦИЕНТА В ПОЛОЖЕНИИ ШЕЗЛОНГА ПРИ АРТРОСКОПИЧЕСКИХ ОПЕРАЦИЯХ НА ПЛЕЧЕВОМ СУСТАВЕ // КРЕМЛЕВСКАЯ МЕДИЦИНА<br><i>клинический вестник</i>. 2021. Т. № 2. С. 43-49.
Аннотация
Неврологические осложнения, иногда и достаточно серьезные, могут возникать у пациентов в положении шезлонга при выполнении артроскопических операций на плечевом суставе. Основной причиной возникновения неврологических осложнений является артериальная гипотензия и, как следствие, возникающая гипоперфузия головного мозга после изменения положения тела пациента в условиях общей анестезии. Различные клинические исследования продемонстрировали, что в положении шезлонга происходит изменение региональной оксигенации головного мозга и церебрального кровотока. Безусловно, с целью профилактики развития осложнений необходимо проведение клинических исследовании для того, чтобы определить частоту нежелательных неврологических побочных эффектов, выбор оптимального необходимого неврологического мониторинга, которые позволяли бы предупреждать неблагоприятные нейрокогнитивные осложнения, выявление минимального безопасного уровня артериального давления во время операции для отдельных категорий пациентов, с целью своевременной коррекции интраоперационной гипотензии.Литература
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25. Lee S. W. et al. Effect of beach chair position on bispectral index values during arthroscopic shoulder surgery //Korean journal of anesthesiology. – 2014. – V. 67. – №. 4. – P. 235. doi: 10.4097/kjae.2014.67.4.235.
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27. Aguirre J. A. et al. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome //Journal of clinical anesthesia. – 2016. – V. 35. – P. 456-464. doi: 10.1016/j.jclinane.2016.08.035.
28. Gillespie R. et al. The safety of controlled hypotension for shoulder arthroscopy in the beach-chair position //JBJS. – 2012. – V. 94. – №. 14. – P. 1284-1290. doi: 10.2106/JBJS.J.01550.
29. Salazar D. et al. Cerebral desaturation events during shoulder arthroscopy in the beach chair position: patient risk factors and neurocognitive effects //Journal of shoulder and elbow surgery. – 2013. – V. 22. – №. 9. – P. 1228-1235. doi: 10.1016/j.jse.2012.12.036.
30. Murphy G. S. et al. Effect of ventilation on cerebral oxygenation in patients undergoing surgery in the beach chair position: a randomized controlled trial //British journal of anaesthesia. – 2014. – V. 113. – №. 4. – P. 618-627. doi: 10.1093/bja/aeu109.
31. Koh J. L. et al. Neer Award 2012: cerebral oxygenation in the beach chair position: a prospective study on the effect of general anesthesia compared with regional anesthesia and sedation //Journal of shoulder and elbow surgery. – 2013. – V. 22. – №. 10. – P. 1325-1331. doi: 10.1016/j.jse.2013.01.035.
32. Soeding P. F. et al. Effect of norepinephrine on the haemodynamic state and cerebral oxygen saturation during anaesthesia in the upright position //British journal of anaesthesia. – 2013. – V. 111. – №. 2. – P. 229-234. doi: 10.1093/bja/aet024.
2. Luostarinen T. et al. Prone versus sitting position in neurosurgery—differences in patients' hemodynamic management //World neurosurgery. – 2017. – V. 97. – P. 261-266. doi:10.1016/j.wneu.2016.10.005.
3. Pohl A., Cullen D. J. Cerebral ischemia during shoulder surgery in the upright position: a case series //Journal of clinical anesthesia. – 2005. – V. 17. – №. 6. – P. 463-469. doi: 10.1016/j.jclinane.2004.09.012.
4. Drummond J. C., Lee R. R., Howell Jr J. P. Focal cerebral ischemia after surgery in the «beach chair» position: the role of a congenital variation of circle of Willis anatomy //Anesthesia & Analgesia. – 2012. – V. 114. – №. 6. – Р. 1301-1304. doi: 10.1213/ANE.0b013e31823aca46.
5. Villevieille T. et al. Arthroscopic shoulder surgery and ischemic cerebral complications //Annales francaises d'anesthesie et de reanimation. – 2012. – V. 31. – №. 11. – P. 914-918. doi: 10.1016/j.annfar.2012.08.010.
6. Wong F. Y. et al. Tissue oxygenation index measured using spatially resolved spectroscopy correlates with changes in cerebral blood flow in newborn lambs //Intensive care medicine. – 2009. – V. 35. – №. 8. – P. 1464-1470. doi: 10.1007/s00134-009-1486-4.
7. Rasmussen M. B. et al. Quantifying cerebral hypoxia by near-infrared spectroscopy tissue oximetry: the role of arterial-to-venous blood volume ratio //Journal of biomedical optics. – 2017. – V. 22. – №. 2. – P. 025001. doi: 10.1117/1.JBO.22.2.025001.
8. de Tournay-Jetté E. et al. The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery //Journal of cardiothoracic and vascular anesthesia. – 2011. – V. 25. – №. 1. – P. 95-104. doi: 10.1053/j.jvca.2010.03.019
9. Casati A. et al. Continuous monitoring of cerebral oxygen saturation in elderly patients undergoing major abdominal surgery minimizes brain exposure to potential hypoxia //Anesthesia & Analgesia. – 2005. – V. 101. – №. 3. – P. 740-747. doi: 10.1213/01.ane.0000166974.96219.cd.
10. Plachky J. et al. Regional cerebral oxygen saturation is a sensitive marker of cerebral hypoperfusion during orthotopic liver transplantation //Anesthesia & Analgesia. – 2004. – V. 99. – №. 2. – P. 344-349. doi: 10.1213/01.ANE.0000124032.31843.61.
11. Salazar D. et al. Neurocognitive deficits and cerebral desaturation during shoulder arthroscopy with patient in beach-chair position: a review of the current literature //Am J Orthop (Belle Mead NJ). – 2016. – V. 45. – №. 3. – P. E63-8.
12. Murphy G. S. et al. Cerebral oxygen desaturation events assessed by near-infrared spectroscopy during shoulder arthroscopy in the beach chair and lateral decubitus positions //Anesthesia & Analgesia. – 2010. – V. 111. – №. 2. – P. 496-505. doi: 10.1213/ANE.0b013e3181e33bd9.
13. Moerman A. T. et al. Cerebral oxygen desaturation during beach chair position //European Journal of Anaesthesiology| EJA. – 2012. – V. 29. – №. 2. – P. 82-87. doi: 10.1097/EJA.0b013e328348ca18.
14. Closhen D. et al. Influence of beach chair position on cerebral oxygen saturation: a comparison of INVOS and FORE-SIGHT cerebral oximeter //Journal of neurosurgical anesthesiology. – 2013. – V. 25. – №. 4. – P. 414-419. doi: 10.1097/ANA.0b013e3182973349.
15. Songy C. E. et al. The effect of the beach-chair position angle on cerebral oxygenation during shoulder surgery //Journal of shoulder and elbow surgery. – 2017. – V. 26. – №. 9. – P. 1670-1675. doi: 10.1016/j.jse.2017.03.018.
16. Mori Y. et al. Cerebral oxygenation in the beach chair position before and during general anesthesia in patients with and without cardiovascular risk factors //Journal of clinical anesthesia. – 2015. – V. 27. – №. 6. – P. 457-462. doi: 10.1016/j.jclinane.2015.06.007.
17. Smelt W. L., De Lange J. J., Booij L. H. Cardiorespiratory effects of the sitting position in neurosurgery //Acta Anaesthesiologica Belgica. – 1988. – V. 39. – №. 4. – P. 223-231. doi: 10.1097/00132586-198102000-00033.
18. Pin-on P., Schroeder D., Munis J. The hemodynamic management of 5177 neurosurgical and orthopedic patients who underwent surgery in the sitting or “beach chair” position without incidence of adverse neurologic events //Anesthesia & Analgesia. – 2013. – V. 116. – №. 6. – P. 1317-1324. doi: 10.1213/ANE.0b013e31828446bb.
19. YaDeau J. T. et al. Stroke, regional anesthesia in the sitting position, and hypotension: a review of 4169 ambulatory surgery patients //Regional Anesthesia & Pain Medicine. – 2011. – V. 36. – №. 5. – P. 430-435-430-435. doi: 10.1097/AAP.0b013e318228d54e.
20. YaDeau J. T. et al. Cerebral oximetry desaturation during shoulder surgery performed in a sitting position under regional anesthesia //Canadian Journal of Anesthesia/Journal canadien d'anesthésie. – 2011. – V. 58. – №. 11. – P. 986-992. doi: 10.1007/s12630-011-9574-7.
21. Trentman T. L. et al. More hypotension in patients taking antihypertensives preoperatively during shoulder surgery in the beach chair position //Canadian Journal of Anesthesia/Journal canadien d'anesthésie. – 2011. – V. 58. – №. 11. – P. 993. doi: 10.1007/s12630-011-9575-6.
22. Ozzeybek D. et al. Comparison of the haemodynamic effects of interscalene block combined with general anaesthesia and interscalene block alone for shoulder surgery //Journal of international medical research. – 2003. –V. 31. – №. 5. – P. 428-433. doi: 10.1177/147323000303100512.
23. Kurth C. D. et al. Cerebral oxygen saturation-time threshold for hypoxic-ischemic injury in piglets //Anesthesia & Analgesia. – 2009. – Т. 108. – №. 4. – P. 1268-1277. doi: 10.1213/ane.0b013e318196ac8e.
24. Laflam A. et al. Shoulder surgery in the beach chair position is associated with diminished cerebral autoregulation but no differences in postoperative cognition or brain injury biomarker levels compared with supine positioning: the anesthesia patient safety foundation beach chair study //Anesthesia and analgesia. – 2015. – V. 120. – №. 1. – P. 176. doi: 10.1213/ANE.0000000000000455.
25. Lee S. W. et al. Effect of beach chair position on bispectral index values during arthroscopic shoulder surgery //Korean journal of anesthesiology. – 2014. – V. 67. – №. 4. – P. 235. doi: 10.4097/kjae.2014.67.4.235.
26. Aguirre J. et al. Cerebral oxygenation in patients undergoing shoulder surgery in beach chair position: comparing general to regional anesthesia and the impact on neurobehavioral outcome //Revista española de anestesiología y reanimación. – 2014. – V. 61. – №. 2. – P. 64-72. doi: 10.1016/j.redar.2013.08.002
27. Aguirre J. A. et al. Cerebral oxygenation in the beach chair position for shoulder surgery in regional anesthesia: impact on cerebral blood flow and neurobehavioral outcome //Journal of clinical anesthesia. – 2016. – V. 35. – P. 456-464. doi: 10.1016/j.jclinane.2016.08.035.
28. Gillespie R. et al. The safety of controlled hypotension for shoulder arthroscopy in the beach-chair position //JBJS. – 2012. – V. 94. – №. 14. – P. 1284-1290. doi: 10.2106/JBJS.J.01550.
29. Salazar D. et al. Cerebral desaturation events during shoulder arthroscopy in the beach chair position: patient risk factors and neurocognitive effects //Journal of shoulder and elbow surgery. – 2013. – V. 22. – №. 9. – P. 1228-1235. doi: 10.1016/j.jse.2012.12.036.
30. Murphy G. S. et al. Effect of ventilation on cerebral oxygenation in patients undergoing surgery in the beach chair position: a randomized controlled trial //British journal of anaesthesia. – 2014. – V. 113. – №. 4. – P. 618-627. doi: 10.1093/bja/aeu109.
31. Koh J. L. et al. Neer Award 2012: cerebral oxygenation in the beach chair position: a prospective study on the effect of general anesthesia compared with regional anesthesia and sedation //Journal of shoulder and elbow surgery. – 2013. – V. 22. – №. 10. – P. 1325-1331. doi: 10.1016/j.jse.2013.01.035.
32. Soeding P. F. et al. Effect of norepinephrine on the haemodynamic state and cerebral oxygen saturation during anaesthesia in the upright position //British journal of anaesthesia. – 2013. – V. 111. – №. 2. – P. 229-234. doi: 10.1093/bja/aet024.