ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

ORTHOPEDIC ANESTHESIA

Sinan Değirmencioğlu

Konya City Hospital, Department of Anesthesiology and Reanimation, Konya, Türkiye

Değirmencioğlu S. Orthopedic Anesthesia. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.355-365.

ABSTRACT

  • Bone cement implantation syndrome is a condition that may lead to embolism and cardiopulmonary instability due to increased intramedullary pressure, and its management requires discontinuation of nitrous oxide, hemodynamic monitoring, and controlled cement injection.
  • The application of a pneumatic tourniquet provides effective hemorrhage control in extremity surgery; however, appropriate pressure and duration adjustments, along with meticulous patient monitoring, are essential to prevent embolism, nerve injury, and hemodynamic alterations.
  • Fat embolism syndrome is a severe clinical condition triggered by long bone fractures and surgical interventions, characterized by hypoxia, neurological impairment, and petechiae; early diagnosis, fracture stabilization, supportive treatment, and appropriate ventilation strategies are crucial in reducing mortality.
  • Venous thromboembolism carries a high risk following lower extremity surgery; while regional anesthesia reduces venous stasis, the timing of anticoagulant administration is crucial in preventing neuraxial complications.
  • Hip surgery is a high-risk procedure for perioperative complications, particularly in geriatric patients, where optimal patient positioning and anesthesia selection are crucial; neuraxial anesthesia, in particular, is an effective approach in reducing mortality and morbidity.
  • Total hip arthroplasty is a surgical procedure performed in advanced-stage joint diseases, where neuraxial anesthesia and blood loss reduction strategies should be prioritized during the intraoperative period.
  • Total knee replacement is a surgical procedure performed for advanced joint degeneration, requiring optimal perioperative management; postoperative pain control should be ensured through regional anesthesia and multimodal analgesia to facilitate early mobilization and enhance the recovery process.
  • In shoulder surgery, maintaining cerebral perfusion, selecting appropriate anesthesia, and ensuring effective postoperative analgesia are of critical importance; the interscalene block is an effective technique but should be carefully evaluated for risks such as pulmonary complications and brachial plexus injury.

Keywords: Bone cements; Embolism; Fat; Hip; Knee; Arthroplasty

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