Position for Shoulder Surgery
The use of the "beach chair," "barber's chair," or semirecumbent
position is increasing in popularity in parallel with surgical procedures on the
shoulder. The key element of the position is that it provides anterior and posterior
access to the shoulder, with the upper extremity freely mobile. Extreme rotation
of the head away from the operative side can result in stretching of the brachial
plexus during surgical manipulation. Figure
28-12
shows one method of securing the endotracheal tube and head to prevent
movement and accidental extubation. The surgical field is clearly higher than the
heart, so air embolism is a risk. An impressive complication of shoulder arthroscopy
Figure 28-11
for midfemoral fractures, the patient is placed on the
fracture table in the lateral position with the legs spaced and positioned to allow
roentgenography at an angle in several planes. (Adapted from Day LJ: Unusual
positions: Orthopedics: Surgical aspects. In Martin
JT [ed]: Positioning in Anesthesia and Surgery, 2nd ed. Philadelphia, WB Saunders,
1987, p 229.)
is rapid, progressive, and complete airway obstruction, caused by extravasation of
the fluid used during the visualization out of the capsule and into the tissues of
the neck.[37]
