The Effect of Compression Stockings on Cerebral Desaturation Events in Obese Patients Undergoing Shoulder Arthroscopy in the Beach-Chair Position

Arthroscopy. 2015 Dec;31(12):2352-64. doi: 10.1016/j.arthro.2015.06.017. Epub 2015 Aug 3.

Abstract

Purpose: To determine if the use of thigh-high compression stockings could decrease the incidence of cerebral desaturation events (CDEs) in patients with a body mass index (BMI) of 30 kg/m(2) or greater undergoing shoulder arthroscopy in the beach-chair position (BCP).

Methods: Between December 2013 and May 2014, 23 patients aged 18 years or older with a BMI of 30 kg/m(2) or greater undergoing shoulder arthroscopy in the BCP were monitored intraoperatively using near-infrared spectroscopy while wearing thigh-high compression stockings. Data obtained on these patients were compared with data from a previous cohort at our institution comprising 24 patients with a BMI of 30 kg/m(2) or greater who underwent elective shoulder arthroscopy in the BCP with the same monitoring but without wearing compression stockings. The incidence of CDEs was identified in each group.

Results: The incidence of CDEs in the group with compression stockings was 4% (1 of 23) compared with 18% (7 of 24) in the group without compression stockings (P = .048). There were no statistically significant differences in mean age (53.0 years v 53.3 years, P = .91), mean BMI (34.5 kg/m(2)v 36.2 kg/m(2), P = .21), or various medical comorbidities between the treatment group and control group. There was a significant difference in the operative time between the treatment group (156.6 minutes) and control group (94.1 minutes) (P < .001).

Conclusions: The use of thigh-high compression stockings may decrease the incidence of CDEs in obese patients undergoing shoulder arthroscopy in the BCP.

Level of evidence: Level IV, therapeutic case series.

Trial registration: ClinicalTrials.gov NCT01996813.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthroscopy / methods
  • Female
  • Humans
  • Hypoxia, Brain / etiology
  • Hypoxia, Brain / prevention & control*
  • Joint Diseases / complications
  • Joint Diseases / surgery*
  • Male
  • Middle Aged
  • Obesity / complications*
  • Oxygen / analysis
  • Patient Positioning / adverse effects
  • Posture / physiology*
  • Prospective Studies
  • Shoulder Joint / surgery*
  • Spectroscopy, Near-Infrared
  • Stockings, Compression*

Substances

  • Oxygen

Associated data

  • ClinicalTrials.gov/NCT01996813