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Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study

Spinal anaesthesia is an established component of perioperative management for fast-track lower limbs arthroplasty. Short-acting local anaesthetics may present an interesting option for primary non-complicated knee (TKA) and hip (THA) arthroplasty. We describe the perioperative outcomes in patients...

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Autores principales: Alhefeiti, Khaleifah, Patrascu, Ana-Maria, Lustig, Sebastien, Aubrun, Frederic, Dziadzko, Mikhail
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572724/
https://www.ncbi.nlm.nih.gov/pubmed/36233638
http://dx.doi.org/10.3390/jcm11195771
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author Alhefeiti, Khaleifah
Patrascu, Ana-Maria
Lustig, Sebastien
Aubrun, Frederic
Dziadzko, Mikhail
author_facet Alhefeiti, Khaleifah
Patrascu, Ana-Maria
Lustig, Sebastien
Aubrun, Frederic
Dziadzko, Mikhail
author_sort Alhefeiti, Khaleifah
collection PubMed
description Spinal anaesthesia is an established component of perioperative management for fast-track lower limbs arthroplasty. Short-acting local anaesthetics may present an interesting option for primary non-complicated knee (TKA) and hip (THA) arthroplasty. We describe the perioperative outcomes in patients operated under fixed 50 mg spinal chloroprocaine for total hip and knee replacement. In this retrospective case series study, 65 patients were analysed (median age 65 years, 55% females, benefit from THA (n = 31), TKA (n = 25), and unicompartmental knee arthroplasty (n = 9)). In all cases, anaesthesia duration (87 min) was sufficient for successful surgery (52 min). Up to 45% of patients (THA and less in TKA) developed postoperative pain in the post-anaesthesia care unit (PACU), requiring intravenous morphine titration (up to 7.5 mg). One patient developed severe breakthrough pain requiring advanced regional analgesia. The median PACU stay was up to 97 min (less in TKA), and the incidence of nausea and urinary retention was low. All patients were able to start physical therapy on the same day of surgery. These findings encourage the use of a short-acting agent for spinal anaesthesia in patients with primary non-complicated arthroplasty; however, the relay analgesia should be systematically implemented to avoid breakthrough pain in PACU.
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spelling pubmed-95727242022-10-17 Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study Alhefeiti, Khaleifah Patrascu, Ana-Maria Lustig, Sebastien Aubrun, Frederic Dziadzko, Mikhail J Clin Med Article Spinal anaesthesia is an established component of perioperative management for fast-track lower limbs arthroplasty. Short-acting local anaesthetics may present an interesting option for primary non-complicated knee (TKA) and hip (THA) arthroplasty. We describe the perioperative outcomes in patients operated under fixed 50 mg spinal chloroprocaine for total hip and knee replacement. In this retrospective case series study, 65 patients were analysed (median age 65 years, 55% females, benefit from THA (n = 31), TKA (n = 25), and unicompartmental knee arthroplasty (n = 9)). In all cases, anaesthesia duration (87 min) was sufficient for successful surgery (52 min). Up to 45% of patients (THA and less in TKA) developed postoperative pain in the post-anaesthesia care unit (PACU), requiring intravenous morphine titration (up to 7.5 mg). One patient developed severe breakthrough pain requiring advanced regional analgesia. The median PACU stay was up to 97 min (less in TKA), and the incidence of nausea and urinary retention was low. All patients were able to start physical therapy on the same day of surgery. These findings encourage the use of a short-acting agent for spinal anaesthesia in patients with primary non-complicated arthroplasty; however, the relay analgesia should be systematically implemented to avoid breakthrough pain in PACU. MDPI 2022-09-29 /pmc/articles/PMC9572724/ /pubmed/36233638 http://dx.doi.org/10.3390/jcm11195771 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alhefeiti, Khaleifah
Patrascu, Ana-Maria
Lustig, Sebastien
Aubrun, Frederic
Dziadzko, Mikhail
Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
title Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
title_full Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
title_fullStr Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
title_full_unstemmed Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
title_short Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
title_sort perioperative outcomes in patients who received spinal chloroprocaine for total hip or knee arthroplasty—consecutive case series study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572724/
https://www.ncbi.nlm.nih.gov/pubmed/36233638
http://dx.doi.org/10.3390/jcm11195771
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