Learning objectives
- Describe the advantages and risks of the beach chair position
- Manage patients presenting for surgery in the beach chair position
Background
- Patients are often positioned in the beach chair or sitting position for shoulder surgery, fossa craniotomy, and post-c-spine surgery
Advantages
- Improved surgical access
- Decreased brachial traction injury
- Ease of setup and conversion to an open approach
- Decreased risk of bleeding
Risks
- Hypotension
- Decrease in cerebral perfusion
- Venous air embolism
- Paradoxical air embolism
- Excessive neck flexion
- Bradycardia or cardiac arrest
- Macroglossia
- Upper airway obstruction
- Pneumocephalus
- Subdural hematoma
- Quadriplegia
- Stroke
Management
Management of patients presenting for surgery in the beach chair position comprises minimizing the risk of complications, mainly by maintaining cerebral perfusion.
Before positioning the patient, review the risks.
Beach chair management in the Anesthesia Assistant App.
Suggested reading
- Murphy GS, Greenberg SB, Szokol JW. Safety of Beach Chair Position Shoulder Surgery: A Review of the Current Literature. Anesth Analg. 2019;129(1):101-118.
- Hewson DW, Oldman M, Bedforth NM. Regional anaesthesia for shoulder surgery. BJA Education. 2019;19(4):98-104.
- Rozet I, Vavilala MS. Risks and benefits of patient positioning during neurosurgical care. Anesthesiol Clin. 2007;25(3):631-x.
