Anesthetic considerations for joint replacement surgery in hemophilic arthropathy: a comprehensive review.

Anesthesia and pain medicine Pub Date : 2024-07-01 Epub Date: 2024-07-23 DOI:10.17085/apm.24047
H Shafeeq Ahmed, Purva Reddy Jayaram
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Abstract

Managing hemophilia in patients undergoing joint replacement surgery requires a comprehensive approach encompassing preoperative assessment, meticulous intraoperative care, and tailored postoperative management. Evaluation of joint integrity, bleeding history, and inhibitor presence guides surgical planning and hemostatic therapy selection to optimize outcomes. During surgery, careful attention to factor replacement, antibiotic prophylaxis, anesthetic techniques, and orthopedic strategies minimizes bleeding risk and enhances surgical success. Postoperatively, effective pain management, continued hemostatic therapy, and individualized rehabilitation programs are vital for facilitating recovery and preventing complications. Close monitoring for potential complications, such as periprosthetic joint infection and recurrent hemarthrosis, allows for prompt intervention when necessary. Overall, a collaborative approach involving hematologists, orthopedic surgeons, anesthesiologists, and rehabilitation specialists ensures comprehensive care tailored to the unique needs of patients with hemophilia undergoing joint replacement surgery, ultimately optimizing outcomes and improving quality of life. This holistic approach addresses the multifaceted challenges posed by hemophilia and joint replacement surgery, providing patients with the best possible chance for successful outcomes and long-term joint function. By integrating specialized expertise from multiple disciplines and implementing evidence-based strategies, healthcare providers can effectively manage hemophilia in the context of joint replacement surgery, mitigating risks and maximizing benefits for patients.

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血友病关节病关节置换手术的麻醉注意事项:全面回顾。
对接受关节置换手术的血友病患者进行管理需要采取全面的方法,包括术前评估、细致的术中护理和量身定制的术后管理。对关节完整性、出血史和抑制剂存在情况的评估可指导手术计划和止血疗法的选择,从而优化治疗效果。在手术过程中,对因子置换、抗生素预防、麻醉技术和矫形策略的仔细关注可最大限度地降低出血风险,提高手术成功率。术后,有效的疼痛管理、持续的止血治疗和个性化的康复计划对于促进康复和预防并发症至关重要。密切监测潜在并发症,如假体周围关节感染和复发性血肿,以便在必要时及时干预。总之,由血液科医生、整形外科医生、麻醉科医生和康复科专家共同参与的合作方法确保了针对接受关节置换手术的血友病患者的独特需求提供全面的护理,最终优化治疗效果并提高生活质量。这种综合治疗方法可以应对血友病和关节置换手术带来的多方面挑战,为患者提供最佳的治疗效果和长期关节功能。通过整合多个学科的专业知识并实施循证策略,医疗服务提供者可以在关节置换手术中有效地管理血友病,降低风险并为患者带来最大益处。
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