scholarly journals Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty

2019 ◽  
Vol 8 (6) ◽  
pp. 778 ◽  
Author(s):  
Ha-Jung Kim ◽  
Hee-Sun Park ◽  
Yon-Ji Go ◽  
Won Uk Koh ◽  
Hyungtae Kim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Spinal Anesthesia ◽  
Knee Arthroplasty ◽  
Lower Risk ◽  
Kidney Injury ◽  
Anesthetic Technique ◽  
Anesthesia Group ◽  
Total Knee ◽  
Spinal Anesthesia Group

Recent studies have reported the advantages of spinal anesthesia over general anesthesia in orthopedic patients. However, little is known about the relationship between acute kidney injury (AKI) after total knee arthroplasty (TKA) and anesthetic technique. This study aimed to identify the influence of anesthetic technique on AKI in TKA patients. We also evaluated whether the choice of anesthetic technique affected other clinical outcomes. We retrospectively reviewed medical records of patients who underwent TKA between January 2008 and August 2016. Perioperative data were obtained and analyzed. To reduce the influence of potential confounding factors, propensity score (PS) analysis was performed. A total of 2809 patients and 2987 cases of TKA were included in this study. A crude analysis of the total set demonstrated a significantly lower risk of AKI in the spinal anesthesia group. After PS matching, the spinal anesthesia group showed a tendency for reduced AKI, without statistical significance. Furthermore, the spinal anesthesia group showed a lower risk of pulmonary and vascular complications, and shortened hospital stay after PS matching. In TKA patients, spinal anesthesia had a tendency to reduce AKI. Moreover, spinal anesthesia not only reduced vascular and pulmonary complications, but also shortened hospital stay.

scholarly journals The Effect of Intraoperative Sounds of Saw and Hammer on Psychological Condition in Patients with Total Knee Arthroplasty: Prospective Randomized Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Erkam Kömürcü ◽  
Hasan Ali Kiraz ◽  
Burak Kaymaz ◽  
Umut Hatay Gölge ◽  
Gürdal Nusran ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Knee Arthroplasty ◽  
Randomized Study ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Negative Effect ◽  
Total Knee ◽  
Spinal Anesthesia Group

Purpose. Surgical procedures are likely to be stressful for patients and their families. Total knee arthroplasty (TKA) is a major surgical procedure used in the treatment of osteoarthritis. During this procedure the sounds of the saw and hammer may irritate the patient and adversely affect mood. The present study examines the effect of these intraoperative sounds during TKA on postoperative mood and anxiety, by comparing two different anesthetic procedures.Methods. A total of 40 patients who underwent TKA for grade IV gonarthrosis participated in the study. Patients were randomly divided into two groups: 20 patients in the general anesthesia group and 20 patients in the spinal anesthesia group. Mood and anxiety changes were evaluated using the Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) instruments, respectively.Results. The postoperative POMS value in the spinal anesthesia group was definitively higher than the general anesthesia group, though the difference in preoperative and postoperative POMS and STAI scores between the two groups was not significant.Conclusion. It would seem that sounds of hammer and saw have no evident negative effect on patient’s mood. Regional anesthesia is advisable for TKA patients and appropriate sedation can be administered during the operation if needed.

scholarly journals Greater Rates of Acute Kidney Injury in African American Total Knee Arthroplasty Patients

2019 ◽  
Vol 34 (6) ◽  
pp. 1240-1243
Author(s):  
Tanner N. Womble ◽  
John D. King ◽  
Dustin H. Hamilton ◽  
Max A. Shrout ◽  
Cale A. Jacobs ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
African American ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Total Knee

Acute Kidney Injury After Placement of an Antibiotic-Impregnated Cement Spacer During Revision Total Knee Arthroplasty

2012 ◽  
Vol 27 (6) ◽  
pp. 1221-1227.e2 ◽  
Author(s):  
Travis J. Menge ◽  
John R. Koethe ◽  
Cathy A. Jenkins ◽  
Patty W. Wright ◽  
Andrew A. Shinar ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Revision Total Knee Arthroplasty ◽  
Cement Spacer ◽  
Total Knee

scholarly journals Early postoperative albumin level following total knee arthroplasty is associated with acute kidney injury

Medicine ◽  
2016 ◽  
Vol 95 (31) ◽  
pp. e4489 ◽  
Author(s):  
Ha-Jung Kim ◽  
Won-Uk Koh ◽  
Sae-Gyeol Kim ◽  
Hyeok-Seong Park ◽  
Jun-Gol Song ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Kidney Injury ◽  
Albumin Level ◽  
Total Knee

scholarly journals Ultrasound Guided Femoral Nerve Block with Bupivacaine versus Bupivacaine and Tramadol for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty under Spinal Anesthesia

2021 ◽  
pp. 23-32
Author(s):  
Mohammad Mostafa Abo Farrag ◽  
Laila Elahwal ◽  
Hesham Mohammad Maroof ElDomairy ◽  
Mohammad Ibrahem Okab
Keyword(s):  
Total Knee Arthroplasty ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Group I ◽  
Total Knee

Background: Effective pain control in Total knee arthroplasty (TKA) is important for optimizing the rehabilitation process in order to achieve patient satisfaction with a good functional outcome as well as reduce hospitalization duration and costs. Combined use of aesthetic with tramadol has been reported to achieve a longer duration of sensory and motor block. The aim of this study is to evaluate the quality and duration of postoperative analgesia produced by ultrasound guided femoral nerve block (FNB) by bupivacaine versus (bupivacaine & tramadol) in patients undergoing total knee arthroplasty under spinal anesthesia. Methods: This prospective randomized controlled double blinded study was carried out on 60 patients aged above 50 years; American Society of Anesthesiologists physical status (ASA) I-III scheduled for total knee arthroplasty under spinal anesthesia. Patients were randomized to one of two equal groups: Group I control (C): received FNB with 30 ml 0.25% bupivacaine. Group II tramadol (T): received FNB with 30ml 0.25% bupivacaine and 100 mg tramadol. Results: Postoperative heart rate was significantly increased in group C than group T at 8h, 12h, 16h and 24h. Postoperative mean arterial blood pressure was significantly increased in group C than group T at 6h, 8h, 12h, 16h and 24h. There were 30 (100%) patients required rescue analgesia in group C and 19 (63.33%) patients in group T which was increased significantly in group C than group T. The time to first analgesic requirement was significantly decreased in group C than group T. Total morphine consumption was increased significantly in group C than group T. VAS was increased significantly in group C than group T at 6, 8, 12, 16 and 24 hours. Adverse effects were insignificantly different between both groups. Conclusion: Adding tramadol (100 mg) to 0.25% bupivacaine (to a volume of 30 ml) during US guided FNB of TKA under spinal anesthesia was associated with better postoperative analgesia when compared with 0.25% bupivacaine alone.

scholarly journals Spinal versus general anesthesia for patients undergoing outpatient total knee arthroplasty: a national propensity matched analysis of early postoperative outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark C. Kendall ◽  
Alexander D. Cohen ◽  
Stephanie Principe-Marrero ◽  
Peter Sidhom ◽  
Patricia Apruzzese ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Adverse Events ◽  
General Anesthesia ◽  
Knee Arthroplasty ◽  
Anesthetic Management ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Short Term ◽  
Knee Replacements ◽  
Total Knee

Abstract Background A comparison of different anesthetic techniques to evaluate short term outcomes has yet to be performed for patients undergoing outpatient knee replacements. The aim of this investigation was to compare short term outcomes of spinal (SA) versus general anesthesia (GA) in patients undergoing outpatient total knee replacements. Methods The ACS NSQIP datasets were queried to extract patients who underwent primary, elective, unilateral total knee arthroplasty (TKA) between 2005 and 2018 performed as an outpatient procedure. The primary outcome was a composite score of serious adverse events (SAE). The primary independent variable was the type of anesthesia (e.g., general vs. spinal). Results A total of 353,970 patients who underwent TKA procedures were identified comprising of 6,339 primary, elective outpatient TKA procedures. Of these, 2,034 patients received GA and 3,540 received SA. A cohort of 1,962 patients who underwent outpatient TKA under GA were propensity matched for covariates with patients who underwent outpatient TKA under SA. SAE rates at 72 h after surgery were not greater in patients receiving GA compared to SA (0.92%, 0.66%, P = 0.369). In contrast, minor adverse events were greater in the GA group compared to SA (2.09%, 0.51%), P < 0.001. The rate of postoperative transfusion was greater in the patients receiving GA. Conclusions The type of anesthetic technique, general or spinal anesthesia does not alter short term SAEs, readmissions and failure to rescue in patients undergoing outpatient TKR surgery. Recognizing the benefits of SA tailored to the anesthetic management may maximize the clinical benefits in this patient population.

Sign in / Sign up

Export Citation Format

Share Document