Study Summary

59 patients with shoulder pathology requiring arthroscopic shoulder surgery in the beach chair position were randomised to receive continuous noninvasive finger-cuff arterial pressure monitoring or intermittent oscillometric arterial pressure monitoring. The primary outcome of interest was the time-weighted average mean arterial pressure (MAP) below 65 mmHg during surgery. Secondary outcomes included cerebral oxygen desaturation episodes, severe hypotensive episodes, time to correction of hypotension, and haemodynamic treatment requirements. Outcomes were assessed intraoperatively throughout the surgical monitoring period, which lasted approximately 90 minutes in both groups. Overall, the results of the study revealed that continuous finger-cuff monitoring did not significantly reduce intraoperative hypotension compared with intermittent monitoring, although treatment of hypotension occurred earlier in the continuous monitoring group. Additionally, cerebral oxygen saturation remained relatively stable in both groups, while MAP was positively correlated with cerebral oxygenation. The findings suggest that continuous noninvasive blood pressure monitoring alone may not meaningfully reduce hypotensive burden during beach chair shoulder surgery without more aggressive haemodynamic management strategies.