J Am Acad Orthop Sur
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J Am Acad Orthop Sur · Jan 2015
Review Comparative StudyA comparison of the lateral decubitus and beach-chair positions for shoulder surgery: advantages and complications.
Arthroscopic or open shoulder surgery can be performed using the lateral decubitus or beach-chair position. Advantages of the lateral decubitus position include better visualization and instrument access for certain procedures and decreased risk for cerebral hypoperfusion. Complications associated with this position include traction injuries, resulting in neurapraxia, thromboembolic events, difficulty with airway management, and the potential need to convert to an anterior open approach. ⋯ Although rare, patients in this position may experience cerebral hypoperfusion and complications that range from cranial nerve injury to infarction. Other complications related to this position include cervical traction neurapraxia, blindness, and cardiac and embolic events. The surgeon must be cognizant of the complications associated with both positions and take extra care in the initial patient setup and coordination with the anesthesiologist to minimize the risk of complications and morbidity.