Armtutor Effective in Post Shoulder Surgery Therapy

Writing in the Canadian Journal of Anesthesia, 08/29/2011DOI: 10.1007 Terrence L. Trentman et al states that hypotension is common in patients undergoing surgery in the sitting position under general anesthesia, and the risk may be exacerbated by the use of antihypertensive drugs taken preoperatively. The purpose of this study was to compare hypotensive episodes in patients taking antihypertensive medications with normotensive patients during shoulder surgery in the beach chair position.
Medical records of all patients undergoing shoulder arthroscopy during a 44-month period were reviewed retrospectively. The primary endpoint was the number of moderate hypotensive episodes (systolic blood pressure ≤ 85 mmHg) during the intraoperative period. Secondary endpoints included the frequency of vasopressor administration, total dose of vasopressors, and fluid administered. Values are expressed as mean (standard deviation).
The results showed that of 384 patients who underwent shoulder surgery, 185 patients were taking no antihypertensive medication, and 199 were on at least one antihypertensive drug. The antihypertensive medication group had more intraoperative hypotensive episodes [1.7 (2.2) vs 1.2 (1.8); P = 0.01] and vasopressor administrations. Total dose of vasopressors and volume of fluids administered were similar between groups. The timing of the administration of angiotensin-converting enzyme inhibitors and of angiotensin receptor antagonists (≤ 10 hr vs > 10 hr before surgery) had no impact on intraoperative hypotension.
The conclusions drawn were that preoperative use of antihypertensive medication was associated with an increased incidence of intraoperative hypotension. Compared with normotensive patients, patients taking antihypertensive drugs preoperatively are expected to require vasopressors more often to maintain normal blood pressure.
The ArmTutor with its sister devices (HandTutor, LegTutor and 3DTutor) have proven successful in post operative shoulder surgery and for patients that have suffered from brain or spinal cord injury, MS, CP, Parkinson’s amongst other disease.
The unique devices use a dedicated software that utilizes games to enhance and improve the patient’s fine motor, sensory and cognitive abilities. The ”Tutors” encourage intensive exercises and allow the therapist to gather objective and quantitative information in order to customize the treatment session. Tele rehabilitation is available for those patients that are home bound or who have recovered sufficiently to get their treatment at home. Leading U.S. and foreign hospitals and outpatient clinics now use the devices which can treat adults as well as children.