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Hip arthroplasty anesthesia for

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https://www.readbyqxmd.com/read/28419032/formal-physical-therapy-after-total-hip-arthroplasty-is-not-required-a-randomized-controlled-trial
#1
RANDOMIZED CONTROLLED TRIAL
Matthew S Austin, Brian T Urbani, Andrew N Fleischman, Navin D Fernando, James J Purtill, William J Hozack, Javad Parvizi, Richard H Rothman
BACKGROUND: The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. METHODS: We conducted a single-center, randomized trial of 120 patients undergoing primary, unilateral total hip arthroplasty who were eligible for direct home discharge. The experimental group followed a self-directed home exercise program for 10 weeks...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28403091/effects-of-preoperative-chronic-hypoxemia-on-geriatrics-outcomes-after-hip-arthroplasty-a-hospital-based-retrospective-analysis-study
#2
Furong Zhang, Ruqiang Zhang, Liang He, Jianwei Yin, Fang Wang, Junmin Li
The partial pressure of oxygen decreases as altitude increases, the preoperative chronic hypoxemia (CH) may have a plausible clinical impact. Risk factors for postoperative serious adverse events (pSAEs) in patients living in high altitudes during primary hip arthroplasty (HA) are not clear.This is an observational study embracing patients from January 1, 2011 to December 31, 2015 at Yan'an Hospital of Kunming City, a 1338-bed municipal teaching hospital of Kunming Medical University. Univariate analysis revealed that significant differences between patients with and without preoperative CH occurred in intraoperative hypotension (77 [33%] vs 34 [47%], P = ...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#3
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28366309/hip-arthroplasty-for-fracture-vs-elective-care-one-bundle-does-not-fit-all
#4
Richard S Yoon, Siddharth A Mahure, Lorraine H Hutzler, Richard Iorio, Joseph A Bosco
BACKGROUND: To quantify how baseline differences in patients undergoing hip arthroplasty for fracture vs elective care potentially lead to significant differences in immediate health care outcomes and whether these differences affect feasibility of current bundled payment models. METHODS: New York Statewide Planning and Research Cooperative System database for the years 2000-2014. RESULTS: A total of 76,654 patients underwent total hip arthroplasty or hemiarthroplasty between 2010 and 2014; 82...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28348503/gabapentin-does-not-appear-to-improve-postoperative-pain-and-sleep-patterns-in-patients-who-concomitantly-receive-regional-anesthesia-for-lower-extremity-orthopedic-surgery-a-randomized-control-trial
#5
Jean Daniel Eloy, Christy Anthony, Shawn Amin, Moorice Caparó, Mark C Reilly, Steven Shulman
In recent years, gabapentin has gained popularity as an adjuvant therapy for the treatment of postoperative pain. Numerous studies have shown a decrease in pain score, even with immediate postoperative activity, which is significant for early post-op ambulation and regaining functionality sooner. However, studies have been in conclusive in patients undergoing lower extremity orthopedic surgery. For this reason, we hoped to study the effect of gabapentin on postoperative pain in patients undergoing total knee arthroplasty, total hip arthroplasty, or a hip fracture repair...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28306737/alcohol-consumption-and-the-risk-of-postoperative-mortality-and-morbidity-after-primary-hip-or-knee-arthroplasty-a-register-based-cohort-study
#6
Torill A Rotevatn, Henrik Bøggild, Christinna R Olesen, Christian Torp-Pedersen, Rikke N Mortensen, Per F Jensen, Charlotte Overgaard
OBJECTIVE: To investigate the implications of low and moderate preoperative alcohol consumption on postoperative mortality and morbidity after primary hip and knee arthroplasty. METHODS: A total of 30,799 patients who underwent primary hip or knee arthroplasty between January 1st, 2005 and October 8th, 2011 with information on preoperative alcohol consumption (0 grams of pure alcohol/week, >0-168 g/week, >168-252 g/week, and >252 g/week) were identified through the Danish Anesthesia Database...
2017: PloS One
https://www.readbyqxmd.com/read/28277419/complications-after-continuous-posterior-lumbar-plexus-blockade-for-total-hip-arthroplasty-a-retrospective-cohort-study
#7
Catherine W Njathi, Rebecca L Johnson, Ruple S Laughlin, Darrell R Schroeder, Adam K Jacob, Sandra L Kopp
BACKGROUND AND OBJECTIVES: While benefits of regional anesthesia in total hip arthroplasty (THA) are well documented, data describing the incidence of complications related to the use of posterior lumbar plexus blockade for THA remain limited. Our primary aim was to evaluate the incidence of infectious, bleeding, and neurological complications related specifically to the use of continuous posterior lumbar plexus block for elective THA. METHODS: We reviewed the electronic medical records of all adult patients who underwent elective THA with continuous posterior lumbar plexus blockade between December 1, 2004, and April 30, 2015, using the Mayo Clinic Total Joint Registry...
March 8, 2017: Regional Anesthesia and Pain Medicine
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
#8
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/28236548/quantifying-blood-loss-and-transfusion-risk-after-primary-vs-conversion-total-hip-arthroplasty
#9
Jared M Newman, Matthew R Webb, Alison K Klika, Trevor G Murray, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. METHODS: A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41)...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28222674/administration-of-hes-in-elderly-patients-undergoing-hip-arthroplasty-under-spinal-anesthesia-is-not-associated-with-an-increase-in-renal-injury
#10
Yuanyuan Zhang, Yonghao Yu, Junya Jia, Wenli Yu, Rubin Xu, Licheng Geng, Ying Wei
BACKGROUND: Hydroxyethyl starch (HES) is applied to achieve volume expansion during surgery; however, nephrotoxicity may be induced in patients with sepsis. Simultaneously, neutrophil gelatinase-associated lipocalin (NGAL) and IL-18 have been illustrated as pivotal indicators to diagnose the acute kidney injury (AKI) early. This multi-center, randomized, double-blinded, placebo-controlled study aimed to investigate whether 6% HES 130/0.4 administration caused postoperative AKI, which can be revealed by urinary and plasma NGAL and IL-18 estimations in elderly patients with normal renal function undergoing hip arthroplasty under spinal anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28214338/sciatic-neuropathy-due-to-popliteal-fossa-nerve-block
#11
Adam Aubuchon, W David Arnold, Anna Bracewell, J Chad Hoyle
INTRODUCTION: Sciatic neuropathy following popliteal nerve block (PNB) for regional anesthesia is considered uncommon but has been increasingly recognized in the literature. We identified a case of sciatic neuropathy that occurred after bunionectomy during which a PNB had been performed. METHODS: To understand the frequency of PNB-related sciatic neuropathy we performed a retrospective review of sciatic neuropathies at our center over a five year period. RESULTS: Forty-five cases of sciatic neuropathy were reviewed...
February 18, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28153458/ten-year-trends-and-independent-risk-factors-for-unplanned-readmission-following-elective-total-joint-arthroplasty-at-a-large-urban-academic-hospital
#12
Matthew A Varacallo, Leah Herzog, Nader Toossi, Norman A Johanson
BACKGROUND: Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. METHODS: Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28106610/-opt-out-and-access-to-anesthesia-care-for-elective-and-urgent-surgeries-among-u-s-medicare-beneficiaries
#13
Eric C Sun, Franklin Dexter, Thomas R Miller, Laurence C Baker
BACKGROUND: In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS: Using Medicare administrative claims data, we examined whether "opt out" reduced the distance traveled by patients, a common measure of access, for patients undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28094482/real-time-ultrasound-guided-spinal-anesthesia-in-patients-with-predicted-difficult-anatomy
#14
Hesham Elsharkawy, Ankit Maheshwari, Rovnat Babazade, Anahi Perlas, Sherif Zaky, Loran M Soliman
BACKGROUND: There are limited reports of lumbar neuraxial blocks using real-time ultrasound in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real time ultrasound guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. METHODS: Following institutional review board approval patients scheduled for total hip or knee arthroplasty with expected difficulty to perform spinal anesthesia were included...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27903340/-the-clinical-application-of-lumbar-plexus-the-first-posterior-sacral-foramina-block-for-hip-arthroplasty-in-elderly-patients
#15
J Li, X J Ke, Y Liu, K Chen, M B Chen, W Mei
Objective: To evaluate the clinical efficacy of lumbar plexus-the first posterior sacral foramina block as an anesthesia technique for hip arthroplasty in elderly patients. Methods: Forty-four patients, aged 60-91 years, weighing 37-100 kg, American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, underwent elective hip arthroplasty in Tongji Hospital from February 2015 to January 2016.All patients received lumbar plexus and the first posterior sacral foramina block.The first posterior sacral foramina puncture point of 23 cases were located by traditional positioning method, the others were orientated via ultrasonic method...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27898510/the-effect-of-implementation-of-preoperative-and-postoperative-care-elements-of-a-perioperative-surgical-home-model-on-outcomes-in-patients-undergoing-hip-arthroplasty-or-knee-arthroplasty
#16
Thomas R Vetter, Joydip Barman, James M Hunter, Keith A Jones, Jean-Francois Pittet
BACKGROUND: The Perioperative Surgical Home (PSH) seeks to remedy the currently highly fragmented and expensive perioperative care in the United States. The 2 specific aims of this health services research study were to assess the association between the preoperative and postoperative elements of an initial PSH model and a set of (1) clinical, quality, and patient safety outcomes and (2) operational and financial outcomes, in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27879955/hypobaric-versus-isobaric-spinal-levobupivacaine-for-total-hip-arthroplasty
#17
Alessandro Vergari, Luciano Frassanito, Roberta Nestorini, Cosimo T Caputo, Angelo Chierichini, Enrico DI Stasio, Marco Rossi
BACKGROUND: Spinal anesthesia (SA) in the lateral decubitus position is often used to perform total hip arthroplasty (THA). Hypobaric local anesthetic ensures enhanced and prolonged sensory and motor block in the involved side. The aim of this study was to compare the intraoperative anesthetic efficacy of hypobaric with isobaric levobupivacaine solutions for THA. METHODS: Forty patients scheduled to elective THA were allocated into two groups: isobaric levobupivacaine group (IL group) and hypobaric levobupivacaine group (HL group)...
April 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#18
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
April 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27793238/pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#19
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27788137/postoperative-mortality-after-hip-fracture-surgery-a-3-years-follow-up
#20
Oya Kilci, Canan Un, Ozlem Sacan, Mehmet Gamli, Semih Baskan, Mustafa Baydar, Bulent Ozkurt
BACKGROUND AND AIMS: To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. METHODS: The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded...
2016: PloS One
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