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Total hip replacement anesthesia

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https://www.readbyqxmd.com/read/29195854/hypothermia-in-total-joint-arthroplasty-a-wake-up-call
#1
Jordan B Simpson, Vijai S Thomas, Sabir K Ismaily, Pavel I Muradov, Philip C Noble, Stephen J Incavo
BACKGROUND: Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation, and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients. METHODS: In a retrospective review of 204 patients undergoing primary hip and 179 undergoing primary knee replacement surgeries, time and temperature parameters were collected from the electronic health records from preoperative and postoperative recovery room nursing assessments, intraoperative anesthesia records, and floor nursing notes...
November 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29145334/concurrent-one-stage-total-knee-and-hip-arthroplasty-due-to-sequel-of-juvenile-rheumatoid-arthritis-a-case-report
#2
Afshin Taheriazam, Amin Saeidinia
RATIONALE: Rheumatoid arthritis is a chronic systemic connective tissue disease. Total hip and knee arthroplasties are common major orthopaedic procedures worldwide. PATIENT CONCERNS: To date, no studies have presented 1-stage concurrent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA). We reported a case which is, to our knowledge, the first description of both THA and TKA in a patient with RA simultaneously...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29071370/determination-of-the-median-effective-dose-ed50-of-bupivacaine-and-ropivacaine-unilateral-spinal-anesthesia-prospective-double-blinded-randomized-dose-response-trial
#3
WeiBing Wang, YuanHai Li, AiJiao Sun, HongPing Yu, JingChun Dong, Huang Xu
BACKGROUND: Unilateral spinal anesthesia (USpA) has been reported to potentiate spinal anaesthesia and is used in geriatric patients. The purpose of this study was to determine the median effective dose (ED50) of 0.5% hypobaric bupivacaine and 0.5% hypobaric ropivacaine USpA for geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery. METHODS: A total of 60 geriatric patients (age ≥ 70 years) undergoing elective hip replacement surgery were enrolled in this study...
October 25, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28894068/-the-effects-of-30-minutes-of-pre-warming-on-core-body-temperature-systolic-blood-pressure-heart-rate-postoperative-shivering-and-inflammation-response-in-elderly-patients-with-total-hip-replacement-under-spinal-anesthesia-a-randomized-double-blind-controlled
#4
You Mi Cheon, Haesang Yoon
PURPOSE: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. METHODS: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013...
August 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28870301/perioperative-pain-management-and-anesthesia-a-critical-component-to-rapid-recovery-total-joint-arthroplasty
#5
REVIEW
Matthew W Russo, Nancy L Parks, William G Hamilton
Multimodal pain management has become the standard of care following total hip and knee replacement. The advantages include decreasing opioid consumption and its associated side effects, facilitating earlier mobilization, and faster return to function. An effective rapid recovery protocol includes the use of multiple different types of medications targeting each area of the pain pathway, preemptive analgesia, regional nerve blockade, and local infiltration analgesia.
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28690539/neurimmirs-and-postoperative-delirium-in-elderly-patients-undergoing-total-hip-knee-replacement-a-pilot-study
#6
Rui Dong, Lingling Sun, Yayuan Lu, Xi Yang, Mian Peng, Zongze Zhang
Objective: Postoperative delirium (POD) is a frequent complication after surgery and its occurrence is associated with poor outcomes. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The purpose of this study was to investigate the associations between the preoperative expression levels of microRNA (miR)-146a, miR-125b, and miR-181c in cerebrospinal fluid (CSF) and serum and the development and severity of POD. Methods: Forty elderly patients aged 65 years old and older admitted for elective total hip/knee replacement under spinal anesthesia...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#7
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28607788/a-case-of-fracture-redislocation-of-the-hip-caused-by-a-depressed-fracture-of-the-femoral-head-similar-to-a-hill-sachs-lesion
#8
Yoshihiko Okudera, Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Ken Sasaki, Tetsuya Kawano, Yosuke Iwamoto, Naohisa Miyakoshi, Yoichi Shimada
The present case shows a case of fracture-redislocation of the hip caused by a depressed fracture of the femoral head similar to a Hill-Sachs lesion. A 59-year-old man fell from a roof and his left hip joint was dislocated posteriorly. He was admitted to a nearby hospital, and he was referred to our hospital more than 24 hours after injury. Computed tomography (CT) suggested a bone chip from the posterior wall of the acetabulum roof and a depressed femoral head that cut into the posterior margin of the acetabulum roof...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28599629/dose-dependent-effects-of-intravenous-methoxamine-infusion-during-hip-joint-replacement-surgery-on-postoperative-cognitive-dysfunction-and-blood-tnf-%C3%AE-level-in-elderly-patients-a-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Shenghui Sun, Defeng Sun, Lin Yang, Jun Han, Ruochuan Liu, Lijie Wang
BACKGROUND: Postoperative cognitive dysfunction (POCD), common in elderly patients, is thought to be closely associated with intraoperative instability of hemodynamics and excessive excretion of tumor necrosis factor-α (TNF-α). Methoxamine is a blood-pressure increasing drug commonly used for maintaining intraoperative hemodynamics. Methoxamine potentially promotes TNF-α expression, leading to an increased risk of POCD. This study aimed to investigate the dose-dependent effect of methoxamine on the incidence of early POCD and blood TNF-α level...
June 9, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28549416/management-of-intra-operative-acute-pulmonary-embolism-during-general-anesthesia-a-case-report
#10
Yuanyuan Mao, Shuai Wen, Gezi Chen, Wei Zhang, Yanqiu Ai, Jingjing Yuan
BACKGROUND: Acute pulmonary embolism (APE) can be life-threatening. Early detection is even more difficult for patients under general anesthesia as common symptoms are not available and the pathophysiological course of intra-operative APE is influenced by procedures of surgery and anesthesia, which makes patients under general anesthesia a distinctive group. CASE PRESENTATION: We report a case of APE during orthopedic surgery under general anesthesia. A 64-year-old female with atrial fibrillation and surgical history of varicosity underwent total right hip replacement surgery under general anesthesia...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28533694/the-improved-quality-of-postoperative-analgesia-after-intrathecal-morphine-does-not-result-in-improved-recovery-and-quality-of-life-in-the-first-6-months-after-orthopedic-surgery-a-randomized-controlled-pilot-study
#11
Nilufar Foadi, Matthias Karst, Anika Frese-Gaul, Niels Rahe-Meyer, Stefan Krömer, Christian Weilbach
OBJECTIVE: In orthopedic surgery, it is well known that the use of intrathecal morphine (ITM) leads to an improved quality of postoperative analgesia. Little is known how this improved analgesia affects the long-term course after surgery. STUDY DESIGN: A randomized, double-blind trial. SETTING: Academic medical center. SUBJECTS: Forty-nine patients undergoing total hip or knee replacement surgery in spinal anesthesia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28439446/thoracic-unilateral-spinal-cord-injury-after-spinal-anaesthesia-for-total-hip-replacement-fate-or-mistake
#13
Costa Fabio, Del Buono Romualdo, Agrò Felice Eugenio, Tambone Vittoradolfo, Vitali Andrea Massimiliano, Ricci Giovanna
Spinal anaesthesia is the most preffered anesthesia technique for total hip replacement, and its complications range from low entity (insignificant) to life threatening. The incidence of neurologic complications after neuraxial anaesthesia is not perfectly clear, although there are several described cases of spinal cord ischaemia. We present a case of unilateral T8-T11 spinal cord ischaemia following L2-L3 spinal anaesthesia for total hip replacement. Magnetic resonance imaging showed a hyperintense T8-T11 signal alteration on the leftside of paramedian spinal cord...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28378007/do-shorter-lengths-of-stay-increase-readmissions-after-total-joint-replacements
#14
Udai S Sibia, Kip A Waite, Maura A Callanan, Adrian E Park, Paul J King, James H MacDonald
BACKGROUND: Enhanced recovery after surgery protocols for total joint replacements (TJRs) emphasize early discharge, yet the impact on readmissions is not well documented. We evaluate the impact of a one-day length of stay (LOS) discharge protocol on readmissions. METHODS: We conducted a retrospective review of all primary TJRs (hip and knee) from April 2014 to March 2015. Patients who had adequate support to be discharged home were categorized into 2 groups, 1-day (n = 174) vs 2-day (n = 285) LOS groups...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28244911/effects-of-the-length-of-stay-on-the-cost-of-total-knee-and-total-hip-arthroplasty-from-2002-to-2013
#15
Ilda B Molloy, Brook I Martin, Wayne E Moschetti, David S Jevsevar
BACKGROUND: Utilization of total knee and hip arthroplasty has greatly increased in the past decade in the United States; these are among the most expensive procedures in patients with Medicare. Advances in surgical techniques, anesthesia, and care pathways decrease hospital length of stay. We examined how trends in hospital cost were altered by decreases in length of stay. METHODS: Procedure, demographic, and economic data were collected on 6.4 million admissions for total knee arthroplasty and 2...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27469916/anesthesia-strategies-and-perioperative-optimization-for-patients-with-ankylosing-spondylitis-undergoing-total-hip-replacement-surgery
#16
Zi-jia Liu, Xue-rong Yu, Yu Dong, Qin Zhou, Xiao-shuang Zou, Xi-sheng Weng, Yu-guang Huang
Objective To identify the characteristics of anesthesia and perioperative management for ankylosing spondylitis (AS) patients undergoing total hip arthroplasty (THA). Methods Totally 63 patients scheduled for single THA in PUMC Hospital from January 1st 2013 to June 1st 2015 were included in this retrospective analysis,among whom 21 patients were diagnosed of AS. The perioperative clinical data included:demographic data,American Society of Anesthesiologists (ASA) classification,medical history,airway assessment,preoperative laboratory examinations,electrocardiogram,pulmonary function tests,intubation information,operation time,intraoperative intake and output volume,postoperative hospital stay,and postoperative complications...
June 10, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/27466030/anesthesia-technique-and-mortality-after-total-hip-or-knee-arthroplasty-a-retrospective-propensity-score-matched-cohort-study
#17
Anahi Perlas, Vincent W S Chan, Scott Beattie
BACKGROUND: This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. METHODS: All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus general anesthesia. The primary outcome was 30-day mortality. Secondary outcomes were (1) perioperative myocardial infarction; (2) a composite of major adverse cardiac events that includes cardiac arrest, myocardial infarction, or newly diagnosed arrhythmia; (3) pulmonary embolism; (4) major blood loss; (5) hospital length of stay; and (6) operating room procedure time...
October 2016: Anesthesiology
https://www.readbyqxmd.com/read/27323615/-effects-of-ligustrazine-on-serum-s100%C3%AE-protein-and-neuron-specific-enolase-in-elderly-patients-undergoing-orthopedics-operations
#18
RANDOMIZED CONTROLLED TRIAL
Wei-guo Ni, Qing-feng Hu, Ke Xu, Ying-hua Zhang, Shuai Ding, Sheng-qiang Liu, Chen Xin
OBJECTIVE: To observe effects of Ligustrazine on serum S100p protein and neuron-specific enolase (NSE) in elderly patients undergoing orthopedics operations. METHODS: Totally 60 patients undergoing selective total hip replacement, 65-80 years old, who were in line with American Society of Anesthesiologists (ASA) grade I or II, were randomly assigned to the Ligustrazine group (Group L) and the normal saline control group (Group S). The right internal jugular vein catheters were placedcephalad and ensured theirs tips in jugular venous bulbs after anesthesia induction and tracheal intubation...
April 2016: Chinese Journal of Integrated Traditional and Western Medicine
https://www.readbyqxmd.com/read/27067754/no-difference-in-dislocation-seen-in-anterior-vs-posterior-approach-total-hip-arthroplasty
#19
COMPARATIVE STUDY
Joseph D Maratt, Joel J Gagnier, Paul D Butler, Brian R Hallstrom, Andrew G Urquhart, Karl C Roberts
BACKGROUND: The direct anterior approach (DAA) for total hip arthroplasty (THA) has rapidly become popular, but there is little consensus regarding the risks and benefits of this approach in comparison with a modern posterior approach (PA). METHODS: A total of 2147 patients who underwent DAA THA were propensity score matched with patients undergoing PA THA on the basis of age, gender, body mass index, and American Society of Anesthesia classification using data from a state joint replacement registry...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27049192/contemporary-strategies-for-rapid-recovery-total-hip-arthroplasty
#20
Jeffrey B Stambough, Paul E Beaulé, Ryan M Nunley, John Clohisy
Over the past several years, rapid recovery protocols for total hip arthroplasty have evolved in parallel with advancements in pain management, regional anesthesia, focused rehabilitation, and the patient selection process. As fiscal pressures from payers of health care increase, surgical outcomes and complications are being scrutinized, which evokes a sense of urgency for arthroplasty surgeons as well as hospitals. The implementation of successful accelerated recovery pathways for total hip arthroplasty requires the coordinated efforts of surgeons, practice administrators, anesthesiologists, nurses, physical and occupational therapists, case managers, and postacute care providers...
2016: Instructional Course Lectures
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