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Total hip replacement anesthesia

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<strong>Objective </strong>To identify the characteristics of anesthesia and perioperative management for ankylosing spondylitis (AS) patients undergoing total hip arthroplasty (THA). <strong>Methods </strong>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
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
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
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
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
Alessandro D'Ambrosio, Savino Spadaro, Chiara Natale, Antonella Cotoia, Michele Dambrosio, Gilda Cinnella
BACKGROUND AND AIMS: Continuous spinal anesthesia (CSA) has not been widely used for postoperative analgesia, mainly to avoid complications from the subarachnoid injection. Recently, the introduction of low caliber CSA catheters (Spinocath(®)), has allowed to decrease anesthetics doses and volumes with good analgesia and reduced complications. The aim of this present study was to compare two concentrations of levobupivacaine administered through CSA for postoperative pain management after major orthopedic surgery...
October 2015: Journal of Anaesthesiology, Clinical Pharmacology
Lisbeth Evered, Brendan Silbert, David A Scott, David Ames, Paul Maruff, Kaj Blennow
BACKGROUND: Postoperative cognitive dysfunction (POCD) affects 16 to 21% of the elderly 3 months after anesthesia and surgery and is associated with adverse outcomes. The exact cause of POCD remains unknown. The authors hypothesized that elderly individuals with Alzheimer disease (AD) neuropathology, identified by cerebrospinal fluid (CSF) analysis, would have increased the risk for POCD. METHODS: CSF samples were collected from 59 patients 60 yr or older who received combined spinal and general anesthesia for elective total hip replacement...
February 2016: Anesthesiology
Basim Kamil Hassan, Arne Sahlström, Ram Benny Christian Dessau
BACKGROUND AND PURPOSE OF THE STUDY: Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surgery. METHODS: A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury...
2015: Journal of Orthopaedic Surgery and Research
Karthikeyan Kallidaikurichi Srinivasan, Gabriella Iohom, Frank Loughnane, Peter J Lee
BACKGROUND: Multiple passes and attempts while administering spinal anesthesia are associated with a greater incidence of postdural puncture headache, paraesthesia, and spinal hematoma. We hypothesized that the routine use of a preprocedural ultrasound-guided paramedian technique for spinal anesthesia would reduce the number of passes required to achieve entry into the subarachnoid space when compared with the conventional landmark-guided midline approach. METHODS: One hundred consenting patients scheduled for elective total joint replacements (hip and knee) were randomized into group C (conventional) and group P (preprocedural ultrasound-guided paramedian technique) with 50 in each group...
October 2015: Anesthesia and Analgesia
Tim Dwyer, Michael Drexler, Vincent W S Chan, Daniel B Whelan, Richard Brull
UNLABELLED: Many anesthesiologists may not be familiar with the rate of surgical neurological complications of the hip and knee procedures for which they are providing local anesthetic-based anesthesia and/or analgesia. Part 2 of this narrative review series on neurological complications of elective orthopedic surgery describes the mechanisms and likelihood of peripheral nerve injury associated with some of the most common hip and knee procedures, including arthroscopic hip and knee surgery and total hip and knee replacement...
September 2015: Regional Anesthesia and Pain Medicine
Peter J Kallio, Jenea Nolan, Amy C Olsen, Susan Breakwell, Richard Topp, Paul S Pagel
BACKGROUND: Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery. OBJECTIVES: We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA). PATIENTS AND METHODS: Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled)...
June 2015: Anesthesiology and Pain Medicine
Maurice Jove, David W Griffin, Harold S Minkowitz, Bruce Ben-David, Mark A Evashenk, Pamela P Palmer
BACKGROUND: Complications with IV patient-controlled analgesia include programming errors, invasive access, and impairment of mobility. This study evaluated an investigational sufentanil sublingual tablet system (SSTS) for the management of pain after knee or hip arthroplasty. METHODS: This prospective, randomized, parallel-arm, double-blind study randomized postoperative patients at 34 U.S. sites to receive SSTS 15 μg (n = 315) or an identical placebo system (n = 104) and pain scores were recorded for up to 72 h...
August 2015: Anesthesiology
Lili Xu, Zhiyong Hu, Jianjun Shen, Patrick M McQuillan
SPECIFIC AIM: Cerebral injury caused by hypoperfusion during the perioperative period is one of the main causes of disability and death in patients after major surgery. No effective protective or preventative strategies have been identified. This study was designed to evaluate the effects of Ginkgo biloba extract on cerebral oxygen and glucose metabolism in elderly patients with known, pre-existing cerebral ischemia. METHODS: Sixty ASA (American Society of Anesthesiologists) II-III patients, diagnosed with vertebral artery ischemia by transcranial Doppler ultrasonography (TCD), and scheduled for elective total hip replacement surgery, were enrolled in the study...
April 2015: Complementary Therapies in Medicine
J E Scott, J L Mathias, A C Kneebone
OBJECTIVE: Delirium is common in older adults following total joint replacement (TJR) of the hip and knee. However, reports of the incidence of delirium vary widely, limiting their usefulness. The current meta-analysis therefore examined (1) the incidence of delirium in older patients who underwent TJR and (2) whether these rates vary according to the (a) joint (hip/knee replacement), (b) inclusion/exclusion of patients who underwent simultaneous bilateral surgery, (c) inclusion/exclusion of patients with preexisting cognitive impairments, (d) type of anesthesia (regional/general), (e) method/frequency of assessment, and (f) postoperative interval...
May 2015: General Hospital Psychiatry
Christoffer C Jørgensen, Sten Madsbad, Henrik Kehlet
BACKGROUND: Diabetes is a risk factor for postoperative morbidity, which includes total hip and knee arthroplasty. However, no previous studies have been done in a fast-track setting with optimized perioperative care, including spinal anesthesia, multimodal opioid-sparing analgesia, early mobilization, and discharge to home, which improved postoperative outcome. METHODS: We performed an observational cohort study using prospective data in primary total hip and total knee arthroplasty with a standardized fast-track approach...
January 2015: Anesthesia and Analgesia
Wei-Hung Chen, Kuo-Chuan Hung, Ping-Heng Tan, Hon-Yi Shi
INTRODUCTION: This study explored the effects of general (GA) and neuraxial (NA) anesthesia on the outcomes of primary total joint replacement (TJR) in terms of postoperative mortality, length of stay (LOS), and hospital treatment costs. METHODS: From 1997 to 2010, this nationwide population-based study retrospectively evaluated 7,977 patients in Taiwan who underwent primary total hip or knee replacement. We generated two propensity-score-matched subgroups, each containing an equal number of patients who underwent TJR with either GA or NA...
April 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mariam A Alansari, Ahmed A Abdulmomen
A 70-year-old man underwent total hip replacement surgery under general anesthesia, endotracheal intubation, and controlled ventilation, with the patient in left lateral position. Intraoperatively, the patient was hemodynamically stable, with a normal range of pulse, ECG trace, oxygen saturation as measured by pulse oximetry (Spo2), and end-tidal CO2 (etco2). Five minutes after insertion of the hip prosthesis, his heart rate dropped to 30 beats/min, BP to 40/30 mm Hg, Spo2 to 70%, and etco2 to 10 mm Hg.
November 2014: Chest
Geraldo Ângelo Gonçalves, Eduardo Della Valle Prezzi, Guilherme Marinho Carletti, Giuseppe Chindamo, Tito Henrique Noronha Rocha, Eduardo Varella, Arthur Oswaldo de Abreu Vianna
Anesthetic management of patients with severe chronic obstructive pulmonary disease is extensively discussed, due to the high rates of complications in this subtype of patients submitted to medium and high complexity surgical procedures. The objective of this study is to report use of noninvasive positive pressure mechanical ventilation - bilevel positive airway pressure - and spinal anesthesia in a patient with severe chronic obstructive pulmonary disease during total hip arthroplasty. An 81 year old, male patient with severe chronic obstructive pulmonary disease (GOLD 4) was submitted to total hip arthroplasty due to a femoral bone fracture under spinal anestesia and noninvasive positive pressure mechanical ventilation-bilevel positive airway pressure with expiratory pressure of 7 cmH2O, inspiratory pressure of 15 cmH2O and O2 flow of 3 L/min...
September 2008: Revista Brasileira de Terapia Intensiva
Susan M Goodman, Rebecca Zhu, Mark P Figgie, Wei-Ti Huang, Lisa A Mandl
BACKGROUND: While rates of total hip replacement (THR) in spondyloarthritis are increasing, contemporary outcomes are not well described. OBJECTIVES: This study analyzes 2-year outcomes in a contemporary cohort of ankylosing spondylitis (AS) patients undergoing THR. METHODS: A case-control study was performed using data from an institutional arthroplasty registry. Validated AS cases were matched 4:1 by age and procedure to patients with osteoarthritis (OA)...
October 2014: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Antje Gottschalk, Birgit Rink, Rüdiger Smektala, André Piontek, Björn Ellger, André Gottschalk
STUDY OBJECTIVE: To determine whether spinal anesthesia blunts surgical stress reactions and results in less perioperative hyperglycemia. DESIGN: Prospective, randomized controlled study. SETTING: Operating room of a university hospital. PATIENTS: 68 adult, nondiabetic (n = 40) and diabetic (n = 28), ASA physical status 1, 2, and 3 patients patients undergoing elective total hip replacement. INTERVENTIONS: General or spinal anesthesia was administered...
September 2014: Journal of Clinical Anesthesia
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