Prospective Evaluation of Cognitive Outcomes After Anesthesia on Patients in the Beach Chair Position

In this prospective, randomized, controlled study, investigators used a standardized
anesthesia protocol to maintain the MAP during surgeries done in the BCP. Investigators
hypothesized that, if the MAP was maintained, NIRS monitoring would not change
intra-operative anesthesia management and would not affect the post-operative cognitive
outcomes of participants undergoing surgery in the beach chair position. Investigators
secondarily wanted to document the actual incidence of cerebral desaturation events (CDEs)
recorded by NIRS occurring in participants placed in the BCP if the MAP was strictly
maintained.

Inclusion Criteria:

- at least 18 years of age

- elective shoulder surgery in the beach chair position

Exclusion Criteria:

- less than 18 years of age

- preoperative score of 23 or less on the pre-operative Mini Mental State Exam

- traumatic brain injury

- transient ischemic attack

- cerebrovascular incident

- any apparent clinical neurologic dysfunction

- carotid artery stenosis

- known vascular malformation in head

- inability to have blood pressure measured in the opposite extremity

- malignant hyperthermia