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Anaesthesia for orthopaedic surgery in the elderly 

Anaesthesia for orthopaedic surgery in the elderly
Chapter:
Anaesthesia for orthopaedic surgery in the elderly
Author(s):

Chris Dodds

, Chandra M. Kumar

, and Frédérique Servin

DOI:
10.1093/med/9780198735571.003.0007
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date: 07 June 2020

Arthritis and falls are common in the elderly and hence lead to major bone and joint surgery. Elderly patients may suffer from significant cardiorespiratory, renal, and neurologic dysfunction, and they may be malnourished; therefore, preoperative assessment is essential. Both general and regional anaesthesia techniques are commonly used, but regional anaesthesia, with or without sedation, is preferred. The use of cement during surgery is known to be associated with intraoperative morbidities, as is the use of a tourniquet. Antibiotics are routinely used, but they must be administered before the tourniquet is inflated. The incidence of deep vein thrombosis and pulmonary embolism is high, and prophylaxis should be considered. Blood loss may be excessive, especially during revision surgery; measures should be taken to minimize blood loss. Regional technique, with or without opioids, provides good analgesia. Patient-controlled analgesia (PCA) with an opioid remains a useful method where possible.

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