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The effect of a sequential compression device on hemodynamics in arthroscopic shoulder surgery using beach-chair position.
Arthroscopy 2010; 26(6):729-33A

Abstract

PURPOSE

This study investigated the effect of intermittent compression by a sequential compression device (SCD) on the incidence of hypotension and other hemodynamic variables in the beach-chair position.

METHODS

Fifty healthy patients undergoing elective shoulder arthroscopy under general anesthesia were randomly assigned to either the control group (n = 25) or SCD group (n = 25). A standardized protocol for pre-hydration and anesthetic technique was followed. Hemodynamic variables were measured before (pre-induction values) and 5 minutes after the induction of anesthesia in the supine position (baseline values) and 1, 3, and 5 minutes after the patient was raised to a 70 degrees sitting position. The incidence of hypotension was recorded and treated with ephedrine.

RESULTS

The incidence of hypotension was significantly higher in the control group (16 of 25) than that in the SCD group (7 of 25) (P = .022; odds ratio, 0.219; 95% confidence interval, 0.066 to 0.723). Between the groups, mean arterial pressure, cardiac index, and stroke volume index were significantly higher in the SCD group compared with values in the control group at 1 minute after patients were raised to a 70 degrees sitting position (P = .035, P = .046, and P = .011, respectively).

CONCLUSIONS

This study showed that the use of an SCD could reduce the incidence of hypotension from 64% to 28% and supports hemodynamic variables such as mean arterial pressure and stroke volume index when patients were changed from the supine to the beach-chair position in those undergoing shoulder arthroscopy.

LEVEL OF EVIDENCE

Level I, therapeutic randomized controlled trial.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, South Korea.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20511029

Citation

Kwak, Hyun J., et al. "The Effect of a Sequential Compression Device On Hemodynamics in Arthroscopic Shoulder Surgery Using Beach-chair Position." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 26, no. 6, 2010, pp. 729-33.
Kwak HJ, Lee JS, Lee DC, et al. The effect of a sequential compression device on hemodynamics in arthroscopic shoulder surgery using beach-chair position. Arthroscopy. 2010;26(6):729-33.
Kwak, H. J., Lee, J. S., Lee, D. C., Kim, H. S., & Kim, J. Y. (2010). The effect of a sequential compression device on hemodynamics in arthroscopic shoulder surgery using beach-chair position. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 26(6), pp. 729-33. doi:10.1016/j.arthro.2009.10.001.
Kwak HJ, et al. The Effect of a Sequential Compression Device On Hemodynamics in Arthroscopic Shoulder Surgery Using Beach-chair Position. Arthroscopy. 2010;26(6):729-33. PubMed PMID: 20511029.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of a sequential compression device on hemodynamics in arthroscopic shoulder surgery using beach-chair position. AU - Kwak,Hyun J, AU - Lee,Jong S, AU - Lee,Dong C, AU - Kim,Hong S, AU - Kim,Ji Y, Y1 - 2010/03/03/ PY - 2009/03/15/received PY - 2009/10/01/revised PY - 2009/10/01/accepted PY - 2010/6/1/entrez PY - 2010/6/1/pubmed PY - 2010/10/1/medline SP - 729 EP - 33 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 26 IS - 6 N2 - PURPOSE: This study investigated the effect of intermittent compression by a sequential compression device (SCD) on the incidence of hypotension and other hemodynamic variables in the beach-chair position. METHODS: Fifty healthy patients undergoing elective shoulder arthroscopy under general anesthesia were randomly assigned to either the control group (n = 25) or SCD group (n = 25). A standardized protocol for pre-hydration and anesthetic technique was followed. Hemodynamic variables were measured before (pre-induction values) and 5 minutes after the induction of anesthesia in the supine position (baseline values) and 1, 3, and 5 minutes after the patient was raised to a 70 degrees sitting position. The incidence of hypotension was recorded and treated with ephedrine. RESULTS: The incidence of hypotension was significantly higher in the control group (16 of 25) than that in the SCD group (7 of 25) (P = .022; odds ratio, 0.219; 95% confidence interval, 0.066 to 0.723). Between the groups, mean arterial pressure, cardiac index, and stroke volume index were significantly higher in the SCD group compared with values in the control group at 1 minute after patients were raised to a 70 degrees sitting position (P = .035, P = .046, and P = .011, respectively). CONCLUSIONS: This study showed that the use of an SCD could reduce the incidence of hypotension from 64% to 28% and supports hemodynamic variables such as mean arterial pressure and stroke volume index when patients were changed from the supine to the beach-chair position in those undergoing shoulder arthroscopy. LEVEL OF EVIDENCE: Level I, therapeutic randomized controlled trial. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/20511029/The_effect_of_a_sequential_compression_device_on_hemodynamics_in_arthroscopic_shoulder_surgery_using_beach_chair_position_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(09)00834-2 DB - PRIME DP - Unbound Medicine ER -