Comparison of differences on hemodynamic parameters between patients with and without fluid loading before beach chair position

Aim: In this study; in patients with planned arthroscopic shoulder surgery in the beach chair position, it is aimed to improve hemodynamic changes that develop after the position by performing intravenous crystalloid loading before the position, and to decrease the need for vasopressors and aggressive fluid therapy. Material and Method: Following the approval of the ethics committee, the data of 46 patients were evaluated prospectively. Patients; it was randomized to groups with and without intravenous crystalloid loading prior to the beach chair position. The mean arterial pressure (MAP), heart rate (HR) and stroke volume (SV) and cardiac output (CO) values measured by FloTrac Vigileo were recorded. The data obtained; each group was compared to each other to show the change between supine and beach chair positions and the changes that occurred due to the fluid loading variable between the two groups. Crystalloid, colloid and total fluid usage amounts, ephedrine use, postoperative nausea and vomiting (PONV) rates and surgical satisfaction were evaluated among the groups. Results: MAP measurements of the study group in the beach chair position at 0 min, 5 min and 10 min, respectively (p = 0.035; p = 0.001; p = 0.027); 5 min, 10 min, 30 min CO measurements (p = 0.016; p = 0.009; p = 0.018); 5 min, 10 min, 30 min SV measurements (p = 0.010; p = 0.022; p = 0.036) were significantly higher than the control group. There was a significant difference between the colloid (p = 0.003) and ephedrine usage rates (p = 0.018) according to the groups; In the study group, the use of colloid and ephedrine was significantly lower than the control group, but the amount of crystalloid use was significantly higher (p = 0.016). The POBK rates of the study group are lower than the control group (p = 0.019). Conclusion: Performing intravenous crystalloid loading before positioning for patients who are planned to have shoulder surgery in a beach chair position can protect patients from hypoperfusion. The use of vasopressors can be reduced, more stable hemodynamics, cleaner surgical field and reduction in PONV can be achieved, and the satisfaction of the surgical team and the patient can be increased. Keywords: Beach chair; Crystalloid; Cardiac output; Pulse volume; Postoperative nausea and vomiting; Surgical satisfaction