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BESS Beach Chair Survey

The Beach Chair Position Survey (BESS Research Committee Led Survey)

Consent to participate in The Beach Chair Position Survey

Dear Participant,

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Several advantages have been reported for the beach chair position, including ease of setup and conversion to an open approach, improvements in intra-articular visualisation and orientation, and decreased brachial traction injury. These purported benefits have resulted in a significant increase in the use of the beach chair position by orthopaedic surgeons for shoulder surgery. 

Approximately two-thirds of shoulder surgery is conducted in the beach chair position instead of the lateral decubitus position. 

However, there are risks associated with moving an anaesthetised patient from the supine to the sitting position, which include reductions in blood pressure, cardiac output, and cerebral perfusion, which, if prolonged, may result in serious adverse events such as stroke, coma, spinal cord ischemia, and visual loss.

There are reports of catastrophic and non-catastrophic complications that have been reported in patients undergoing shoulder surgery in the beach chair position. Although the exact aetiology of these adverse events is uncertain, they are presumed to be secondary to hypotension and cerebral hypoperfusion in most reported cases.

We aim to investigate the consensus among shoulder surgeons regarding the use of the Beach chair position in shoulder surgery. We want to understand the strategies used by clinicians to improve brain oxygenation in the beach chair position. This will help us set up new guidelines for using the beach chair position in shoulder surgery.

If you have any questions about the research study, please contact us at 

Starting the survey indicates 
• You have read the above information
• You voluntarily agree to participate

Thank you,

Mr Toby Baring, Consultant Shoulder Surgeon
Dr Simeon West, Consultant Anaesthetist 
Prof. Mohamed Imam, Consultant Shoulder Surgeon

On behalf of the BESS Research committee 
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