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Anesthesia In Orthopedic Surgery

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Raz Smith
Anesthesia In Orthopedic Surgery

The specificities of anesthesia in orthopedic / trauma surgery are: prior to surgery, the assessment of infectious, hemorrhagic and thrombotic risks and patient information on the management of analgesics; during surgery, patient installation, management of specific risks associated with the use of the tourniquet on the limb and surgical cement and the management of risks related to osteotomies and fractures (adipose embolism, hemorrhagic risk, infectious risk ); post-surgery, postoperative (PO) analgesia, improved rehabilitation, and the risk of PO thrombosis; finally, the consideration of specific conditions (spondyloarthropathies and scoliosis).

Lower limb surgery is increasingly common (disabling osteoarthritis) and often affects elderly patients with higher ASA scores and, therefore, more likely to have complications. In planned hip or knee prosthetic surgery, several studies (including several meta-analyzes) are in favor of spinal anesthesia (AS). In total hip replacement (PTA) surgery, the choice of the approach must be guided by the experience of the surgeon and the anatomical characteristics of the patient.

The knee prosthesis (PTG) is, together with the PTA, the most frequent orthopedic prosthesis. After TKA, ineffective PO analgesia is an obstacle to rehabilitation and functional recovery. It is also a source of chronic PO pain (DCPO). Peripheral nerve blocks have shown their interest.

Fracture of the upper extremity of the femur (FESF) is one of the most frequent orthopedic emergencies and is associated with a high risk of decompensation of defects, sliding syndrome, of disability and mortality. The multidisciplinary management by a reference team (anesthesiologists, surgeons, geriatricians) allows to reduce morbidity.

The semi-sitting position, known as the "beach chair", is indicated for installation in shoulder surgery, including arthroscopy.

This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves. The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place.

The multidisciplinary management by a reference team (anesthesiologists, surgeons, geriatricians) allows to reduce morbidity. The semi-sitting position, known as the "beach chair", is indicated for installation in shoulder surgery, including arthroscopy. This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves.

The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place.

The multidisciplinary management by a reference team (anesthesiologists, surgeons, geriatricians) allows to reduce morbidity. The semi-sitting position, known as the "beach chair", is indicated for installation in shoulder surgery, including arthroscopy. This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves.

The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place. surgeons, geriatricians) allows to reduce morbidity.

The semi-sitting position, known as the "beach chair", is indicated for installation in shoulder surgery, including arthroscopy. This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves.

The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place.

surgeons, geriatricians) allows to reduce morbidity. The semi-sitting position, known as the "beach chair", is indicated for installation in shoulder surgery, including arthroscopy. This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves.

The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place. it is indicated for installation in shoulder surgery, including arthroscopy. This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves.

The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place. It is indicated for installation in shoulder surgery, including arthroscopy.

This position exposes to neurological complications secondary to a low cerebral flow or a stretching of the brachial plexus or, also, of the twelfth pair of cranial nerves and compression of the sciatic nerves. The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place. The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place. The use of a peri nervous catheter (BIS) is indicated in all surgeries with a high pain threshold (arthroplasty, rotator cuff surgery, arthrolysis). In peripheral hand and foot surgery, locoregional anesthesia (ALR) occupies an important place.

 

 

 

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Raz Smith
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