Patients receiving beach chair position shoulder surgery are vulnerable to perioperative cerebral desaturation, which is reported to be a risk factor for postoperative cognitive dysfunction. Investigators design this study to test the efficacy of perioperative goal-directed therapy in preventing cerebral desaturation and postoperative cognitive dysfunction in patients receiving beach chair position shoulder surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
70
Patients in the group will follow our mini-fluid challenge test goal-directed therapy protocol, maintaining: * individualized optimised stroke volume by mini-fluid challenge first * keep mean arterial pressure ≧65 mmHg * keep systolic blood pressure ≦140 mmHg * keep cardiac index ≧ 2.5 L/min/cm2
Patients in the group will receive standard perioperative care at the discretion of care-giving anesthesiologist, maintaining: * keep mean arterial pressure ≧65 mmHg * keep systolic blood pressure ≦140 mmHg
Department of Anesthesiology, National Taiwan University Hospital
Taipei, Taiwan
duration of cerebral desaturation events
patients will be monitored with bilateral cerebral oxymetry, and investigators will compare the duration of cerebral desaturation events
Time frame: 3 hours
incidence of cerebral desaturation events
patients will be monitored with bilateral cerebral oxymetry, and investigators will compare the incidence of cerebral desaturation events
Time frame: 3 hours
postoperative cognitive dysfunction assessed by the Taiwan version of questionnaire Qmci
Qmci is a screening assessment developed to detect mild cognitive impairment. It's a 100-point test administered in approximately 10 minutes. A score of 60 or over is considered to be normal. The validity of the Taiwan version of Qmci has been established.
Time frame: 3 days
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