Beach chair position; positions in anesthesia; uses; problems of BCP, how to do a BCP, surgery positioning

1. BEACH CHAIR POSITION
(A SHORT INTRODUCTION)
Dr Rajesh T Eapen
Burjeel Hospital
Muscat

2. POSITIONING
• Patient positioning is a major responsibility that is shared by the entire operating
room team. A balance between optimal surgical positioning and patient
well-being is sometimes required.
• Patient’s position during anesthesia care should be natural- one that would be
well tolerated if the patient were awake and un-sedated.
• Anaesthesia blunts natural compensatory mechanisms, rendering surgical
patients vulnerable to positional changes.

3. BEACH CHAIR POSITION
• The BCP are used for shoulder arthroscopy and neurosurgical procedures,
including posterior cranial fossa and posterior cervical spine.
• Beach chair position is associated with the risk for cerebral under-perfusion.
• Blood pressure must be maintained at a level that guarantees a perfusion
pressure of 60 to 70 mm Hg measured at the level of the foramen magnum
• Patients are sat up at angles varying from 30-90° above the horizontal plane
with appropriate padding and with the head secured in a headrest.

4. BENEFITS OF BCP
• The benefits of the BCP in orthopedic surgery include access to the anterior
and posterior shoulder, reduced traction induced brachial plexus neuropathies,
decreased port placement related injuries, decrease operative time, and more
anatomic position and movement of the shoulder.
• The benefits of the BCP in neurosurgery include access to the posterior cervical
spine and cranial fossa; it also allows for improved venous and cerebrospinal fluid
drainage, potentially lowering intracranial pressure. Additionally, the sitting position
provides better access to the airway and less facial edema compared to the prone
position.

5. Beach Chair Position – illustration
The Beach Chair position was
described in the early 1980s as an
alternative patient position to
address the issue of
brachial plexus traction injuries
experienced by patients in the
Lateral Decubitus position
for orthopedic shoulder
arthroscopy procedures.

7. HOW TO DO IT

13. Position should be such as to give a pleasant sleep