Anesthesia in the orthopedic patient

Abstract

Orthopedic surgical patients pose specific anesthesia related challenges that the perioperative team should be aware of. Many orthopedic patients are candidates for regional anesthetic techniques and the literature suggests potential benefits associated with their use. To avoid potential bleeding complications, perioperative physicians need to consider the effects of a growing number of anticoagulants and antiplatelet agents in use today. Among a number of interventions to reduce perioperative blood loss, the hypotensive epidural technique is utilized for hip arthroplasty patients. As an advanced anesthetic approach, it may be associated with improved perioperative outcomes and represents a routine anesthetic approach at the Hospital for Special Surgery. This chapter reviews many of the anesthetic techniques used in orthopedic patients and discusses their benefits and potentially associated complications.