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Special Concerns of Intraoperative Management in Orthopedic Procedures

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Geriatric Anesthesiology

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Abstract

The incidence of all forms of orthopedic procedures in the geriatric population is continuing to grow as the population ages and continues to desire to be as active as possible. This chapter explores the most common procedures regarding preanesthetic markers for poor or undesirable outcomes and reviews the evidence for proposed anesthetic techniques. The process used is based primarily on currently developed and promulgated guidelines and pathways where available, ERAS protocols if available and large prospective or retrospective trials where there are no guidelines, pathways, or protocols. There are recommendations regarding anesthetic selection where appropriate and the use of special monitoring techniques if supported by outcome data. The most robust protocols and pathways exist for joint replacement procedures followed by lumbar spinal surgery at a very distant second. There are only nascent pathways and protocols in existence for cervical spine surgery; thus, spine surgery generally represents an area that seems ripe for future research and development.

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Authors and Affiliations

  1. Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    John P. Williams (Professor of Anesthesiology)

  2. Department of Anesthesiology, University of Pittsburgh and VA Hospital Pittsburgh, Pittsburgh, PA, USA

    Catalin Ezaru

  3. Department of Anesthesia and Perioperative Care, University of California, Irvine, Orange, CA, USA

    Lynn Cintron

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  1. John P. Williams
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  2. Catalin Ezaru
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  3. Lynn Cintron
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Correspondence to John P. Williams .

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Editors and Affiliations

  1. Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA

    J. G. Reves

  2. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA

    Sheila Ryan Barnett

  3. Department of Anesthesia and Perioperative Medicine, Department of Anesthesiology, Medical University of South Carolina, Charleston, South Carolina, USA

    Julie R. McSwain

  4. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA

    G. Alec Rooke

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Williams, J.P., Ezaru, C., Cintron, L. (2018). Special Concerns of Intraoperative Management in Orthopedic Procedures. In: Reves, J., Barnett, S., McSwain, J., Rooke, G. (eds) Geriatric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-66878-9_25

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