How Surgical Positions Affect Cerebral Oxygenation

How Surgical Positions Affect Cerebral Oxygenation? This study investigates the use of cerebral oximetry in various surgical positions and its impact on cerebral oxygenation. We conducted a literature review through Medline, and Ebscohost, focusing on articles published until October 30, 2023. Our findings indicate that: • Cerebral oxygenation is affected by all surgical positions, with the most significant clinical impact observed in the seated position. • Maintaining cerebral autoregulation is crucial for preventing cerebral hypoxia or desaturation. Upholding a mean arterial pressure above 60 mmHg is essential for this purpose. • Anesthesia can negatively impact cerebral oxygenation by potentially impairing cerebral autoregulation. • Inhalation anesthetics may have a more beneficial effect on cerebral oxygenation compared to intravenous anesthetics. • The risk of cerebral desaturation increases in elderly patients and those with comorbidities. • Standardization of cerebral desaturation definitions is needed to better assess its relationship with postoperative complications. • The position of the blood pressure transducer can affect the accuracy of intraoperative monitoring. In the seated position, placing it at the level of the acoustic meatus provides a more precise assessment. Our study highlights the importance of considering the effects of different surgical positions on cerebral oxygenation. This knowledge can assist anesthesiologists in monitoring patients intraoperatively and potentially preventing postoperative neurological complications. Keywords: Cerebral oximetry, Beach chair, cerebral oxygenation, Prone, Near-infrared spectroscopy