Effect of beach chair position on hemodynamics and cardiovascular events in patients undergoing shoulder arthroscopy for rotator cuff injury combined with shoulder adhesion.

OBJECTIVE: To investigate the effect of beach chair position on hemodynamics and cardiovascular events in patients with rotator cuff injury combined with shoulder adhesion who underwent shoulder arthroscopy, and to provide a theoretical basis for rational placement of surgical position in clinical practice. METHODS: We conducted a retrospective analysis of 148 patients (BC group: n = 78; LD group: n = 70) who underwent shoulder arthroscopy between February 2021 and December 2024. Data were extracted from electronic medical records. Baseline characteristics including operator experience and duration of position maintenance were collected. Surgical parameters (operation time, intraoperative blood loss, urine output, fluid administration), hemodynamic changes measured at baseline, 5 min after positioning, and every 15 min thereafter (differences in systolic/diastolic blood pressure and heart rate before/after positioning), shoulder function recovery (UCLA and ASES scores), range of motion (forward flexion, external rotation, abduction), and cardiovascular complications (arrhythmias requiring intervention defined as episodes lasting >5 min with hemodynamic compromise, myocardial infarction, angina, hypotension) were compared between groups. RESULTS: Comparison of operative time, intraoperative bleeding, intraoperative urine output, intraoperative fluid administration, pre- and post-operative UCLA scores, ASES scores, anterior flexion mobility, external rotation mobility, and abduction mobility between patients in the two groups showed no statistically significant differences (P > 0.05). The difference in systolic blood pressure, diastolic blood pressure and heart rate before and after surgical position placement of patients in the beach chair position group was higher than that of patients in the lateral decubitus position group, and the incidence of cardiovascular events such as cardiac arrhythmia, myocardial infarction, angina pectoris, hypotension and postural hypotension was higher than that of patients in the lateral decubitus position group, and the difference was statistically significant (P < 0.05). CONCLUSION: The beach chair position for shoulder arthroscopy in patients with rotator cuff injury combined with shoulder adhesion is comparable to the lateral decubitus position in terms of surgical efficiency and surgical trauma, and similar to the lateral decubitus position in terms of improving shoulder function and mobility, but it may cause hemodynamic fluctuations and increase the risk of cardiovascular events. Clinical decision-making should prioritize position selection based on specific cardiovascular risk factors, with the lateral decubitus position recommended for patients with pre-existing cardiovascular disease, uncontrolled hypertension, or age over 70 years.