Current Approaches in Hip and Knee Arthroplasty Anaesthesia

Güler, Gülen; Atıcı, Şebnem; Kurt, Ercan; Karaca, Saffet; Yılmazlar, Aysun

doi:10.5152/tjar.2015.26096

Cited by 4 publications

(2 citation statements)

References 65 publications

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“…Moreover regional anaesthesia decreases the incidence of deep vein thrombosis (DVT), pulmonary embolism besides reducing intraoperative blood loss. Monitoring the hemodynamics carefully was paramount to manage this case as severe hypotension is very common in case of massive blood loss during surgery as well as following tourniquet release [16]. Postoperative low molecular weight heparin was started to prevent deep venous thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Osteosarcoma in a 20 Year Old Male Posted for Tumor Excision and Total Knee Replacement: Anaesthetic Concerns with Review of Literature

Kakati¹,

Das²,

Baruah³

et al. 2020

SJAMS

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Osteosarcoma is the most common bone sarcoma having an incidence of 4.6 per million occurring more commonly in the adolescent age group. Treatment of osteosarcoma consists of neoadjuvant chemotherapy for about 10 weeks before and after the reconstructive surgery carried out to salvage the affected limb. The limb saving surgical treatment of osteosarcoma consists of tumour resection and limb reconstruction with a bone graft or endoprosthesis. We hereby discuss the anaesthetic management of a young adult with distal femur osteosarcoma posted for tumour resection and implant of an endoprosthesis with the help of general anaesthesia with adequate perioperative pain management with systemic opioids, paracetamol and epidural analgesia. Optimal haemodynamic management with the help of invasive monitoring helped us not only to manage the perioperative fluid requirements but also kept us vigilant against any untoward side effects of bone cement implantation syndrome. Use of low molecular weight heparin also helped us achieve adequate thrombophrophylaxis in the post-operative period.

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Section: Discussionmentioning

confidence: 99%

Osteosarcoma in a 20 Year Old Male Posted for Tumor Excision and Total Knee Replacement: Anaesthetic Concerns with Review of Literature

Kakati¹,

Das²,

Baruah³

et al. 2020

SJAMS

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“…Neuraxial blocks are frequently used for analgesia and anesthesia in TKA. However, central neuraxial blocks have serious side effects such as motor block, urinary retention, hypotension, nausea, vomiting, and patched block 6 . Thus, peripheral nerve blocks are preferred to avoid these side effects.…”

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasound-guided femoral + anterior sciatic nerve block and genicular nerve block for postoperative pain in total knee arthroplasty

TABUR¹,

Yılmaz

Karasu

et al. 2021

Cukurova Medical Journal

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ÖzPurpose: This study aimed to compare the effectiveness of ultrasound-guided femoral and anterior sciatic (FAS) nerve blocks and genicular (G) nerve blocks as preventive analgesia methods after total knee arthroplasty. Materials and Methods: Fifty patients, aged 55-80 years were divided into two groups preoperatively. Patients in the FAS group (n=25) received 20 mL solutions (10 mL 0.5% bupivacaine, 1 mL [4 mg] dexamethasone, and 9 mL saline) in both femoral and sciatic blocks. Patients in the G group (n=25) received 5 mL solutions (2 mL 0.5% bupivacaine, 1 mL [4 mg] dexamethasone, and 2 mL saline) for each nerve. Patients were assessed 24 h postoperatively, and pain scores, time to first analgesic requirement, total analgesic dose, and postoperative complications during the first 24 h were recorded. Results: VAS scores at postoperative 0, 1, and 6 h and the total amount of tramadol consumed 24 h were lower in the FAS group than in the G group. There was no requirement for additional analgesia in the first 24 h in the FAS group; however, 9 patients required additional analgesia in the G group. Conclusion: USG FAS nerve blocks were superior to the genicular nerve blocks in TKA. Additionally, the genicular block doesn't cause motor block. A genicular block can be considered as an alternative with this regard. Amaç: Çalışmamızın amacı; genel anestezi altında yapılan total diz artroplastisinde (TDA) ultrason eşliğinde uygulanan femoral ve anterior siyatik (FAS) sinir bloğu ile geniküler (G) sinir bloğunun postoperatif analjezik etkilerini araştırmaktır. Gereç ve Yöntem: Ameliyat öncesi 55-80 yaş arası toplam 50 hasta 2 gruba ayrıldı. FAS gruptaki hastalara (n=25) 20 ml solüsyon (10 ml %0.5 Bupivakain+1 ml (4 mg) Deksametazon+ 9 ml serum fizyolojik) ultrason eşliğinde hem femoral hem de siyatik blok uygulamak için uygulandı. G gruptaki hastalara (n=25) her bir geniküler sinire 5 ml solüsyon (2 ml %0.5 Bupivakain+ 1 ml (4 mg) Deksametazon+ 2 ml serum fizyolojik) geniküler blok için ultrason eşliğinde uygulandı. Hastaların postoperatif 24 saat boyunca ağrı skorları, tüketilen opioid miktarları, ilk analjezik gereksinim zamanları, postoperatif komplikasyonları kaydedildi. Bulgular: Postoperatif 0, 1, ve 6. saatteki VAS skorları ve postoperatif 24 saat boyunca tüketilen tramadol miktarı FAS grubunda G grubuna göre anlamlı olarak daha düşük bulundu. Operasyon sonrası FAS grupta hiç ek analjezik gereksinimi olmazken, G grubunda 9 hastada ek analjezik ihtiyacı oldu. Sonuç: Ultrason eşliğinde uygulanan femoral ve siyatik sinir blokları TDA'da geniküler sinir bloklarından üstündü. Ayrıca geniküler bloğun motor bloğa neden olmamasıyla TKA'da postoperatif analjezi amacıyla alternatif olarak kullanılabilecektir

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Exparel/Peripheral Catheter Use in the Ambulatory Setting and Use of Peripheral Catheters Postoperatively in the Home Setting

Bromberg

Dennis

Gritsenko

2017

Curr Pain Headache Rep

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The results regarding liposomal bupivicaine are mixed and mainly focuses on local infiltration and intra-articular injections. There are no known studies specifically comparing liposomal bupivicaine to bupivicaine hydrochloride in ultrasound-guided nerve blocks. There is some encouraging data regarding liposomal bupivicaine, but further studies are needed before it is adopted as a mainstay of treatment. In addition to efficacy, additional investigations are needed to evaluate cost as this could be a major impediment to its implementation.

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Current Approaches in Hip and Knee Arthroplasty Anaesthesia

Cited by 4 publications

References 65 publications

Osteosarcoma in a 20 Year Old Male Posted for Tumor Excision and Total Knee Replacement: Anaesthetic Concerns with Review of Literature

Osteosarcoma in a 20 Year Old Male Posted for Tumor Excision and Total Knee Replacement: Anaesthetic Concerns with Review of Literature

Comparison of ultrasound-guided femoral + anterior sciatic nerve block and genicular nerve block for postoperative pain in total knee arthroplasty

Exparel/Peripheral Catheter Use in the Ambulatory Setting and Use of Peripheral Catheters Postoperatively in the Home Setting

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