Complications and unwanted events during operation of arthroplasty of a hip joint in conditions of regional anesthesia
Objective. Аnalysis of complications and effects of regional anesthesia while doing arthroplasty of a hip joint.
Маterials and methods. In 346 patients, in whom arthroplasty of a hip joint was performed in conditions of various methods of regional anesthesia,intraoperative unwanted effects and events were analyzed. Middle age of the patients have constituted (63.17 ± 12.26) yrs old.
Results. Most time–consuming procedure have appeared a performance of caudal blockade with paravertebral catheterization – (12 ± 2) min. Incidental puncture of vessels was registered while doing the nerves blockade (7% of observations) and caudal blockade with paravertebral blockade (6%). Necessity to change the needle marsh rut have occurred while performance of a psoas–compartment block (22% of observations) and caudal blockade (19%). Analgesia have appeared insufficient most frequently in patients, in whom the nerves blockade was performed (22%). Additional administration of opioids have leaded to the respiration inhibition in 16% patients of this group. Disorders of hemodynamics (аrrhythmia and hypotension) most frequently have occurred in patients, in whom spinal anesthesia was applied. All groups of the patients did not differ statistically significantly in aspects of rate of nausea and vomiting, аs well as tremor.
Conclusion. Blockades of peripheral nerves in aspect of hemodynamics in the patient is safer, than a neuraxial one. They are also less effective and more laborious.
2. Cowan R, Lim JH, Ong T, Kumar A, Sahota O. The challenges of anaesthesia and pain relief in hip fracture care. Drugs Aging. 2017 Jan; 34(1):1-11. doi: 10.1007/s40266-016-0427-5. doi: 10.1007/s40266-016-0427-5.
3. Taheriazam A, Saeidinia A, Keihanian F. Total hip arthroplasty and cardiovascular complications: a review. TherClin Risk Manag. 2018 Apr 13;14:685-90. doi: 10.2147/TCRM.S155918.
4. Johnson RL, Kopp SL, Burkle CM, Duncan CM, Jacob AK, Erwin PJ, et al. Neuraxial vs general anaesthesia for total hip and total knee arthroplasty: a systematic review of comparative-effectiveness research. Br J Anaesth. 2016 Feb;116(2):163-76. doi: 10.1093/bja/aev455.
5. Liang C, Wei J, Cai X, Lin W, Fan Y, Yang F. Efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty. Med Sci Monit. 2017 Aug 2;23:3752-9. doi: 10.12659/MSM.902768.
6. Oganova RG, editor Osnovy dokazatelnoj mediciny. Uchebnoe posobie dlja sistemy poslevuzovskogo i dopolnitel’nogo professional’nogo obrazovanija vrachej. Moskva: Siliceja-Poligraf; 2010. 136 s.
7. Ko S, Goldstein DH, Van Den Kerkhof EG. Definitions of "respiratory depression" with intrathecal morphine postoperative analgesia: a review of the literature. Can J Anaesth. 2003 Aug-Sep;50(7):679-88. doi: 10.1007/BF03018710.
8. Bijker JB, van Klei WA, Kappen TH, van Wolfswinkel L, Moons KG, Kalkman CJ. Incidence of intraoperative hypotension as a function of the chosen definition: Literature definitions applied to a retrospective cohort using automated data collection. Anesthesiology 2007 Aug; 107(2):213-20. doi: 10.1097/01.anes.0000270724.40897.8e.
9. Kryvobok VI, Chaplynskyi RP, Kolomachenko VI, Fesenko VS, vynakhidnyky; Kharkivska medichna akademiia gssliadiplomnoi osvity, patentovlasnyk. Sposib provedennia providnykovoi anestezii kulshovoho suhloba. Patent Ukainy No 60765. 2011 cher 25. [In Ukrainian].
10. Nakamura M, Kamei M, Bito S, Migita K, Miyata S, Kumagai K, et al. Spinal anesthesia increases the risk of venous thromboembolism in total arthroplasty: Secondary analysis of a J-PSVT cohort study on anesthesia. Medicine (Baltimore). 2017 May;96(18):e6748. doi: 10.1097/MD.0000000000006748.
11. Guay J, Parker MJ, Griffiths R, Kopp S. Peripheral nerve blocks for hip fractures. Cochrane Database Syst Rev. 2017 May 11;5:CD001159. doi: 10.1213/ANE.0000000000002489.
12. Lee BH, Braehler M. Use of test dose allows early detection of subdural local anesthetic injection with lumbar plexus block. J Clin Anesth. 2017 Feb;37:111-3. doi: 10.1016/j.jclinane.2016.11.011.
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