Anesthesia for Orthopedic Surgery

Cathleen R Lammers, Cecile Wyckaert

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

Anesthesia care for pediatric orthopedic patients ranges from simple outpatient procedures to complex cases in otherwise healthy patients to those who have syndromes or neuromuscular diseases. Thus, planning for anesthetia requires careful preoperative evaluation of patients, especially since many of these children are under the care of cardiology, pulmonary, neurology, and/or genetics specialists. Specific procedures for clubfoot, hand anomalies, hip dysplasia, Blount disease, osteogenesis imperfecta, arthrogryposis, and juvenile rheumatoid arthritis are discussed. Unique equipment and positioning requirements for pediatric orthopedic cases are also illustrated. Infants and children with septic arthritis can be critically ill and frequently require emergency anesthesia care to make a diagnosis and to begin appropriate antibiotic therapy. Often these patients are neonates/infants or are immunologically compromised. Therefore, a thorough review of the pathophysiological processes helps the anesthesia provider to insure that hospital systems are in place so that safe efficient care, both in the operating room and in the diagnostic imaging suites, can be provided. Challenging anesthetic dilemmas for patients with known or possible neuromuscular diseases are reviewed, including the infant with undiagnosed hypotonia. Finally, we provide a case discussion of a patient who has osteogenesis imperfecta and requires emergency open reduction and internal fixation of a fracture. This case highlights the unique set of problems associated with providing anesthetic care to a patient with this rare brittle bone disease who will require frequent orthopedic repairs.

Original languageEnglish (US)
Title of host publicationGregory's Pediatric Anesthesia: Fifth Edition
PublisherWiley-Blackwell
Pages757-776
Number of pages20
ISBN (Print)1444333461, 9781444333466
DOIs
StatePublished - Dec 9 2011

Keywords

  • Anesthesia for arthrogyposis
  • Anesthesia for cerebral palsy
  • Anesthesia for clubfoot
  • Anesthesia for hip dysplasia
  • Anesthesia for neuromuscular diseases
  • Anesthesia for orthopedic congenital anomalies
  • Anesthesia for septic arthritis
  • Anesthesia for slipped capital femoral epiphysis
  • Osteogenesis imperfecta
  • Pediatric orthopedic anesthesia

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Lammers, C. R., & Wyckaert, C. (2011). Anesthesia for Orthopedic Surgery. In Gregory's Pediatric Anesthesia: Fifth Edition (pp. 757-776). Wiley-Blackwell. https://doi.org/10.1002/9781444345186.ch30