Fluid preloading before beach chair positioning for arthroscopic shoulder procedures: a randomized controlled trial.

Area of Science:

• Anesthesiology
• Surgical Patient Management
• Hemodynamic Monitoring

Background:

• The Beach Chair Position (BCP) offers surgical advantages but risks hemodynamic instability.
• Maintaining Mean Arterial Pressure (MAP) and fluid balance is critical for patient safety.

Purpose of the Study:

• To evaluate the effectiveness of fluid preloading in mitigating hemodynamic instability associated with the BCP.
• To assess the impact of preloading on key hemodynamic variables and patient outcomes.

Main Methods:

• A randomized controlled trial involving 49 patients undergoing elective arthroscopic surgery in the BCP.
• The study group received 10 mL/kg crystalloid fluid 30 minutes prior to BCP positioning.
• Primary outcomes included MAP, Stroke Volume (SV), Heart Rate (HR), and Cardiac Output (CO).

Main Results:

• The preloading group showed significantly higher MAP, CO, and SV post-BCP.
• Increased crystalloid fluid administration and surgical satisfaction were noted in the preloading group.
• The preloading group experienced lower requirements for colloids, ephedrine, and reduced rates of postoperative nausea and vomiting (PONV).

Conclusions:

• Fluid preloading is an effective strategy to preserve hemodynamic stability in patients positioned in the BCP.
• Preloading can improve surgical outcomes and patient comfort by minimizing adverse hemodynamic changes and PONV.