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An emerging area of cerebral oxygen saturation monitoring is the patient undergoing shoulder surgery in the beach chair position for the reasons described above. Cerebral malperfusion may be unappreciated in this setting, where blood pressure monitoring may not be optimal, head position may impede cerebral venous drainage, and positive pressure ventilation impedes an already compromised decreased venous return to the heart because of the beach chair positioning.
http://www.apsf.org/newsletters/html/2009/spring/04_cereboximetry.htm
http://www.apsf.org/newsletters/html/2009/spring/04_cereboximetry.htm