CORR Insights ®: Cerebral desaturation during shoulder arthroscopy: a prospective observational study.

Several authors [1–5] have investigated the effect of upright beach chair positioning on cerebral ischemia during shoulder surgery. Their results indicate a reduction in pressure to levels that would be below presyncopal levels for a patient who is awake. Although few catastrophic events have been documented, the increasing evidence that cerebral ischemia occurs with relative frequency is very concerning given our inability to predict which patients will tolerate this, and which ones will not. This paper adds to our knowledge by investigating a method of detecting ischemia prospectively, and by describing when these ischemic events occurred relative to the time of anesthesia induction. Where Do We Need To Go?