Total Shoulder Arthroplasty Near-infrared Spectroscopy
| Status: | Completed |
|---|---|
| Conditions: | Peripheral Vascular Disease |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 6/20/2018 |
| Start Date: | July 2014 |
| End Date: | October 2015 |
The Effects of Positive-pressure Ventilation on Cerebral Oxygenation and Cardiac Output in Total Shoulder Arthroplasty.
The purpose of this study is to measure cerebral oxygenation and cardiac output of total
shoulder replacement patients undergoing general anesthesia (GA) and positive-pressure
ventilation (PPV).
We hypothesize that cerebral desaturation occurs frequently during GA with PPV, but is rare
during GA and spontaneous ventilation. We also hypothesize that cardiac output usually is
well maintained under GA in the sitting position when epinephrine is used, but that decreased
cardiac output increases the risk of cerebral desaturation.
shoulder replacement patients undergoing general anesthesia (GA) and positive-pressure
ventilation (PPV).
We hypothesize that cerebral desaturation occurs frequently during GA with PPV, but is rare
during GA and spontaneous ventilation. We also hypothesize that cardiac output usually is
well maintained under GA in the sitting position when epinephrine is used, but that decreased
cardiac output increases the risk of cerebral desaturation.
Inclusion Criteria:
- Patients 18-99 undergoing total shoulder arthroplasty
- Planned general anesthesia + brachial plexus nerve block
- Planned arterial catheter
Exclusion Criteria:
- Patients younger than 18 years older and older than 99
- Patients not intending to receive general anesthesia and peripheral nerve block
- Indication for endotracheal tube
- BMI ≥ 30
- Ejection Fraction (if known) < 50%
- Known significant restrictive or obstructive pulmonary disease
- Patients with a history of transient ischemic attack (TIA) or stroke
- Patients with recent signs or symptoms of myocardial ischemia
- Current stress test positive for ischemia
- Intolerance to study medications
- pre-existing contraindication to regional anesthesia
- infection at block site
- pre-existing neurological injury to operative limb
- Non-English speaking patients
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