Anesthetic considerations in orthopedic patients with or without trauma

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Abstract

Anesthetic management of orthopedic patients could vary from normal routine management to more challenging critical management depending on the state in which the patient is presented. Multimodal pain management strategies incorporating opioids, which are the mainstay drugs for pain management, along with adjunctive drugs like local anesthetics (eg, lidocaine), dissociative anesthetics (eg, ketamine), and α-2 agonists (eg, dexmedetomidine), could improve overall patient comfort and help prevent establishment of chronic pain pathways. Also, use of local nerve blocks can prevent nociception right at the point of origin. Orthopedic patients with multiple organ traumas like head injuries, spinal injuries, pulmonary fat embolism, compartment syndrome, or thoracic injuries are high-risk patients in which any life-threatening organ pathology should be addressed before the patient is put under general anesthesia. Interactions of various drugs like antibiotics and neuromuscular blocking agents used in the perioperative period in orthopedic patients should warrant a careful consideration with respect to their interactions with each other and other anesthetic drugs used.

Original languageEnglish (US)
Pages (from-to)107-119
Number of pages13
JournalTopics in Companion Animal Medicine
Volume25
Issue number2
DOIs
StatePublished - May 1 2010
Externally publishedYes

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Keywords

  • Compartment syndrome
  • Fat embolism
  • Orthopedics
  • Pain management
  • Trauma

ASJC Scopus subject areas

  • Small Animals

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