THỰC TRẠNG TỤT HUYẾT ÁP KHI THAY ĐỔI TƯ THẾ VÀ MỘT SỐ YẾU TỐ LIÊN QUAN TRONG PHẪU THUẬT NỘI SOI KHỚP VAI TƯ THẾ NGỒI

Abstract

Introduction: Hypotension during shoulder arthroscopy in the beach chair position (BCP) is a common challenge in anesthesia and resuscitation but underappreciated. Hypertension, diabetes mellitus, advanced age… are some of factors believed to be associated. However, in Vietnam and globally, there are limited reports regarding the correlation between some factors and the incidence of hypotension during surgery using BCP. Objective: To evaluate the status of hypotension and the correlation of specific factors with positional hypotension during shoulder arthroscopy in the beach chair position. Subjects and Methods: An observational study was conducted on patients undergoing shoulder arthroscopic surgery in the BCP. Results: The incidence of hypotension is 100%, with 77.14% experiencing severe hypotension. Hypotension occurred from the first minute following the positional change and persisted for 10-12 minutes; 18/35 patients presented with severe hypotension. The mean volume of fluid resuscitation was 871 ± 143,19ml, and the average dose of ephedrine required for emergency management was 14.6 ± 4,41mg. The risk of severe hypotension tent to increases 3-fold with hypertension, 8-fold with diabetes mellitus, and 2.1-fold for those over 65 years of age. Conclusion: Orthostatic hypotension is a common complication in shoulder surgeries performed in the beach chair position. This risk is further exacerbated in patients over 65, or those with underlying diabetes or hypertension.