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Abstract
The beach chair position (BCP) has been used for shoulder arthroscopic procedures since the early 1980s. The advantages of the conventional BCP (45{u00B0} 90{u00B0} above the horizontal plane) include lack of brachial plexus strain, a reduced risk of direct neurovascular trauma compared with the lateral decubitus approach, excellent intraarticular visualization, and ease of conversion to an open approach if needed . In the United States, approximately two-thirds of arthroscopic and open shoulder procedures are performed with the patient in the sitting position . Although the safety of orthopedic surgery in this position has been well established, rare catastrophic neurologic events have been reported. Pohl and Cullen reported 4 cases of ischemic brain and spinal cord injury occurring after surgery in the BCP. In an additional report, visual loss and ophthalmoplegia were described after shoulder surgery in a sitting position