Anesthetic management in orthopaedic surgery for rheumatic patients

Abstract

Patients with rheumatic diseases frequently require orthopaedic surgeries due to progressive joint damage and deformities. These patients pose unique challenges for anesthesiologists due to systemic involvement, altered anatomy, and chronic pain management needs. This review explores optimal anesthetic strategies to improve surgical outcomes and enhance patient safety in this vulnerable population. Preoperative assessment is crucial for identifying systemic manifestations of rheumatic diseases, including cardiovascular, respiratory, and renal involvement, which can significantly impact anesthetic management. A thorough evaluation helps tailor the anesthetic plan to individual patient needs, ensuring better perioperative care.Regional anesthesia, particularly neuraxial blocks and peripheral nerve blocks, offers significant benefits over general anesthesia in this population. These techniques can reduce postoperative pain, enhance recovery times, and decrease opioid consumption. However, the presence of spinal deformities and anticoagulation therapy in these patients requires careful consideration and meticulous planning. Multimodal analgesia, combining regional techniques with systemic medications, is recommended to manage chronic pain and minimize opioid use postoperatively. Effective pain management strategies are essential for improving postoperative outcomes and patient satisfaction.