An Sang-Mee, Lee Hyun Jung, Woo Jae Hee, Chae Ji Seon, Shin Sang-Jin
Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea.
Department of Orthopedic Surgery, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea.
J Pers Med. 2024 Jun 16;14(6):642. doi: 10.3390/jpm14060642.
The beach chair position (BCP) is widely used in shoulder surgery; however, it frequently leads to hypotension. Hypotension in BCP is prevalent among older patients who are at risk of secondary complications such as ischemic injuries. Therefore, this prospective study aimed to investigate the association and predictive value of frailty, as assessed by ultrasound-measured quadriceps depth and questionnaire, in patients aged ≥65 years undergoing elective shoulder surgery under general anesthesia. A multivariable logistic regression analysis was performed to identify independent risk factors for hypotension in BCP under general anesthesia. Receiver operating characteristic curves were constructed to assess the predictive values of various parameters. The results indicated that a quadriceps depth < 2.3 cm and BCP for an extended period significantly increased the risk of hypotension. The combined consideration of quadriceps depth < 2.3 cm and frailty demonstrated markedly superior predictive power compared with each factor individually. In conclusion, the study findings facilitate the screening and identification of risk factors for older patients undergoing surgery in BCP, thereby enhancing perioperative management.
沙滩椅位（BCP）在肩部手术中广泛应用；然而，它经常导致低血压。BCP引起的低血压在有缺血性损伤等继发性并发症风险的老年患者中很常见。因此，这项前瞻性研究旨在调查在全身麻醉下接受择期肩部手术的≥65岁患者中，通过超声测量股四头肌厚度和问卷调查评估的虚弱与低血压之间的关联及预测价值。进行多变量逻辑回归分析以确定全身麻醉下BCP发生低血压的独立危险因素。构建受试者工作特征曲线以评估各种参数的预测价值。结果表明，股四头肌厚度<2.3 cm以及长时间处于BCP会显著增加低血压风险。与单独考虑每个因素相比，综合考虑股四头肌厚度<2.3 cm和虚弱状态显示出明显更高的预测能力。总之，研究结果有助于筛查和识别在BCP下接受手术的老年患者的危险因素，从而加强围手术期管理。
