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Anesthesia and Analgesia for Hip Surgery

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Hip Joint Restoration

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Abstract

Key preoperative issues in anesthesia for hip surgery are the choice of regional or general anesthesia and optimization of the patients’ medical condition. Intraoperatively, attention should be focused on intraoperative fluid management, avoidance of hypothermia, and minimization of the possibility of allogenic blood transfusion. Postoperatively, the need for enhanced care in higher-risk patients must be recognized. If general anesthesia is used, ideally this should be performed in conjunction with a form of local anesthetic technique. Fixation of hip fractures should be undertaken with minimum delay.

For all types of orthopedic surgery, preventive treatment should be in place to minimize the risk of infection and deep vein thrombosis, as well as management of postoperative pain and nausea.

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References

  1. Moonen AF, Neal TD, Pilot P. Peri-operative blood management in elective orthopaedic surgery. A critical review of the literature. Injury. 2006;37 Suppl 5:S11–6.

    Google Scholar 

  2. Tenholder M, Cushner FD. Intraoperative blood management in joint replacement surgery. Orthopedics. 2004;27(6 Suppl):s663–8.

    PubMed  Google Scholar 

  3. Sculco TP. Minimally invasive total hip arthroplasty: in the affirmative. J Arthroplasty. 2004;19(4 Suppl 1):78–80.

    Article  PubMed  Google Scholar 

  4. Muñoz M, García-Erce JA, Villar I, Thomas D. Blood conservation strategies in major orthopaedic surgery: efficacy, safety and European regulations. Vox Sang. 2009;96(1):1–13.

    Article  PubMed  Google Scholar 

  5. Keating EM, Meding JB. Perioperative blood management practices in elective orthopaedic surgery. J Am Acad Orthop Surg. 2002;10(6):393–400.

    Article  PubMed  Google Scholar 

  6. Ashworth A, Klein AA. Cell salvage as part of a blood conservation strategy in anesthesia. Br J Anaesth. 2010;105(4):401–16.

    Article  CAS  PubMed  Google Scholar 

  7. Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344:e3054.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sharrock NE, Salvati EA. Hypotensive epidural anesthesia for total hip arthroplasty: a review. Acta Orthop Scand. 1996;67(1):91–107.

    Article  CAS  PubMed  Google Scholar 

  9. Moola S, Lockwood C. Effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment. Int J Evid Based Healthc. 2011;9(4):337–45.

    Article  PubMed  Google Scholar 

  10. Scott EM, Buckland R. A systematic review of intraoperative warming to prevent postoperative complications. AORN J. 2006;83(5):1090–104. 1107–13.

    Article  PubMed  Google Scholar 

  11. Ghosh S, Arthur B, Klein AA. NICE guidance on CardioQ(TM) oesophageal Doppler monitoring. Anesthesia. 2011;66(12):1081–3.

    Article  CAS  Google Scholar 

  12. Falck-Ytter Y, Francis CW, Johanson NA, Curley C, Dahl OE, Schulman S, Ortel TL, Pauker SG, Colwell Jr CW. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e278S–325.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Kakkos SK, Warwick D, Nicolaides AN, Stansby GP, Tsolakis IA. Combined (mechanical and pharmacological) modalities for the prevention of venous thromboembolism in joint replacement surgery. J Bone Joint Surg Br. 2012;94(6):729–34.

    Article  CAS  PubMed  Google Scholar 

  14. Savoia G, Alampi D, Amantea B, et al. Postoperative pain treatment SIAARTI Recommendations 2010. Minerva Anestesiol. 2010;76(8):657–67.

    CAS  PubMed  Google Scholar 

  15. Rawal N. Epidural technique for postoperative pain: gold standard no more? Reg Anesth Pain Med. 2012;37(3):310–7.

    Article  PubMed  Google Scholar 

  16. Fero KE, Jalota L, Hornuss C, Apfel CC. Pharmacologic management of postoperative nausea and vomiting. Expert Opin Pharmacother. 2011;12(15):2283–96.

    Article  CAS  PubMed  Google Scholar 

  17. Membership of the Working Party, Griffiths R, Alper J, Beckingsale A, Goldhill D, Heyburn G, Holloway J, Leaper E, Parker M, Ridgway S, White S, Wiese M, Wilson I. Management of proximal femoral fractures 2011. Anesthesia. 2012;67:85–98.

    Article  Google Scholar 

  18. Scottish Intercollegiate Guidelines Network. Management of hip fracture in older people. National Clinical Guideline 111. 2009.

    Google Scholar 

  19. British Orthopaedic Association and British Geriatrics Society. The care of patients with fragility fracture. 2007.

    Google Scholar 

  20. The National Institute for Health and Clinical Excellence. Clinical Guideline 124. The management of hip fracture in adults. 2011.

    Google Scholar 

  21. Royal College of Physicians, British Geriatrics Society, The British Pain Society. The assessment of pain in older people. 2007.

    Google Scholar 

  22. Cuvillon P, Ripart J, Debureaux S, et al. Analgesia after hip fracture repair in elderly patients: the effect of a continuous femoral nerve block: a prospective and randomised study. Ann Fr Anesth Reanim. 2007;26:2–9.

    Article  CAS  PubMed  Google Scholar 

  23. Parker MJ, Griffiths R, Appadu BN. Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures. Cochrane Database Syst Rev. 2002;1:CD001159.

    Google Scholar 

  24. Maxwell MJ, Moran CG, Moppett IK. Development and validation of a preoperative scoring system to predict 30 day mortality in patients undergoing hip fracture surgery. Br J Anaesth. 2008;101:511–7.

    Article  CAS  PubMed  Google Scholar 

  25. Parker MJ, Handoll HHG, Griffiths R. Anesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2004;18:CD000521.

    Google Scholar 

  26. Luger TJ, Kammerlander C, Gosch M, et al. Neuraxial versus general anesthesia in geriatric patients for hip fracture surgery: does it matter. Osteoporos Int. 2010;21:S555–72.

    Article  CAS  PubMed  Google Scholar 

  27. Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248:189–98.

    Article  PubMed  Google Scholar 

  28. Hebl JR, Dilger JA, Byer DE, et al. A pre-emptive multimodal pathway featuring peripheral nerve block improves perioperative outcomes after major orthopedic surgery. Reg Anesth Pain Med. 2008;33:510–7.

    Article  PubMed  Google Scholar 

  29. Raphael M, Jaeger M, van Vlymen J. Easily adoptable total joint arthroplasty program allows discharge home in two days. Can J Anaesth. 2011;58:902–10.

    Article  PubMed  Google Scholar 

  30. Kehlet H, Wilkinson RC, Fischer HB, et al. PROSPECT: evidence-based, procedure-specific postoperative pain management. Best Pract Res Clin Anaesthesiol. 2007;21:149–59.

    Article  PubMed  Google Scholar 

  31. Donaldson AJ, Thomson HE, Harper NJ, Kenny NW. Bone cement implantation syndrome. Br J Anaesth. 2009;102(1):12–22.

    Article  CAS  PubMed  Google Scholar 

  32. Choi PT, Bhandari M, Scott J, et al. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst Rev. 2003;3:CD003071.

    Google Scholar 

  33. Kehlet H, Anderson L. Local infiltration analgesia in joint replacement: the evidence and recommendations for clinical practice. Acta Anaesthesiol Scand. 2011;55:778–84.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Anaesthesia and Intensive Care, Papworth Hospital, Papworth, Cambridge, CB23 3RE, UK

    Sunit Ghosh BSc, MBBS, FRCA, FFICM, Amo Oduro MBBS, FRCA, FRCP & Stephen Webb MBBCh, FRCA, FFICM

Authors
  1. Sunit Ghosh BSc, MBBS, FRCA, FFICM
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  2. Amo Oduro MBBS, FRCA, FRCP
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  3. Stephen Webb MBBCh, FRCA, FFICM
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Corresponding author

Correspondence to Sunit Ghosh BSc, MBBS, FRCA, FFICM .

Editor information

Editors and Affiliations

  1. Orthopedic Surgery, Hip Joint Arthroplasty, Hip Arthroscopy Massachusetts General Hospital, Boston, Massachusetts, USA

    Joseph C. McCarthy

  2. Institute of Orthopedic Research and Education, Houston, Texas, USA

    Philip C. Noble

  3. Consultant Orthopedic Surgeon Orthopedics, The Villar Bajwa Practice, Spire Cambridge Lea Hospital, Cambridge, United Kingdom

    Richard N. Villar

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Ghosh, S., Oduro, A., Webb, S. (2017). Anesthesia and Analgesia for Hip Surgery. In: McCarthy, J., Noble, P., Villar, R. (eds) Hip Joint Restoration. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0694-5_44

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  • DOI: https://doi.org/10.1007/978-1-4614-0694-5_44

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-0693-8

  • Online ISBN: 978-1-4614-0694-5

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