Our understanding and management of rheumatoid arthritis (RA) have greatly improved, but perioperative and anesthetic management remain challenging. RA is not limited to joints; systemic evaluation is thus required when planning perioperative management. Especially, careful airway evaluation is needed; management of airway-related arthritis is challenging. A multidisciplinary approach is essential to prevent complications without exacerbating RA disease activity. Guidelines published in 2017 are available for perioperative management of anti-rheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty. However, the guidelines focus only on anti- rheumatic medications, and do not consider all aspects of perioperative management (including anesthesia). Here, we discuss the perioperative and anesthetic management of patients with RA.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271718 | PMC |
http://dx.doi.org/10.3904/kjim.2021.555 | DOI Listing |
Anesth Analg
January 2025
From the Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Background: Total intravenous anesthesia (TIVA)-based and volatile-based general anesthesia have different effects on cerebral hemodynamics. The current work compares these 2 regimens in acute ischemic stroke patients undergoing endovascular therapy.
Methods: We conducted a systematic literature search across MEDLINE, Embase, Cochrane, CINAHL, Web of Science, and Scopus.
Anesth Analg
January 2025
Department of Anesthesiology, Perioperative, and Pain Medicine Icahn School of Medicine at Mount Sinai New York, New York
Neurochem Res
January 2025
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.
Perioperative neurocognitive disorders (PND) is a common complication affecting the central nervous system, commonly induced by anesthesia and surgical procedures. PND has garnered considerable attention in recent years, not only due to its high morbidity but also its negative impact on patient prognosis, such as increased rates of dementia and mortality. Sevoflurane, a common volatile anesthetic in clinical practice, is increasingly linked to being a potential risk factor for PND with prolonged inhalation, yet effective prevention and treatment methods remain elusive.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesia and Perioperative Medicine, University of California Los Angeles (UCLA) David Geffen School of Medicine, UCLA Health System, Los Angeles, California.
Management of refractory ventricular fibrillation (VF) in patients with implantable implantable cardioverter defibrillator (ICD) presents a therapeutic challenge. We present a case of pediatric refractory ventricular tachycardia (VT)/Torsade de Pointe managed effectively with bilateral stellate ganglion block (SGB) with a long-acting local anesthetic for 18 days as a bridge to more definitive surgical management.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!