The purpose of this study is to measure cerebral oxygenation and cardiac output of total shoulder replacement patients undergoing general anesthesia (GA) and positive-pressure ventilation (PPV). We hypothesize that cerebral desaturation occurs frequently during GA with PPV, but is rare during GA and spontaneous ventilation. We also hypothesize that cardiac output usually is well maintained under GA in the sitting position when epinephrine is used, but that decreased cardiac output increases the risk of cerebral desaturation.
Study Type
OBSERVATIONAL
Enrollment
34
Hospital for Special Surgery
New York, New York, United States
Number of Cerebral Desaturation Events
The number of Cerebral Desaturation Events (CDE) that occured. CDE is defined as a reduction in cerebral tissue oxygen saturation of \>20% from baseline that lasts for 90 seconds or longer.
Time frame: Day of surgery
Cardiac Output (CO)
Cardiac output of patients as measured in liters per minute
Time frame: Day of surgery
Cardiac Index (CI)
Average cardiac index for patients, a measurement of how efficient the heart is pumping. Measured in liters per minute per meters squared of heart size.
Time frame: Day of surgery
Stroke Volume (SV)
Stroke volume, the amount of blood pumped by the left ventricle of the heart with each contraction. Measured in milliliters.
Time frame: Day of surgery
Mean Arterial Pressure (MAP)
mean arterial pressure and noninvasive blood pressure will be represented as a percentage of baseline after surgery. A lower percentage is a worse outcome.
Time frame: Day of surgery
End Tidal Carbon Dioxide (ETCO2)
a lower score is a better outcome.
Time frame: Day of surgery
Intravenous Fluid Volume
Time frame: Day of surgery
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