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16 - Anesthetic Considerations for Orthopedic Trauma

Published online by Cambridge University Press:  18 January 2010

Robert M. Donatiello
Affiliation:
Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York
Andrew D. Rosenberg
Affiliation:
Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York
Charles E. Smith
Affiliation:
Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
Charles E. Smith
Affiliation:
Case Western Reserve University, Ohio
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Summary

Objectives

  1. List the advantages of early fracture fixation.

  2. Discuss risk factors and complications of orthopedic trauma including advanced age, obesity, intoxication, compartmental syndrome, positioning injuries, and fat embolism.

  3. Evaluate anesthetic concerns for patients with hip fracture, pelvic injury, and traumatic spinal cord injuries.

  4. Review the options for postoperative pain control after orthopedic trauma including patient-controlled analgesia (PCA), epidural analgesia, and peripheral nerve blocks.

INTRODUCTION

Almost 60 million people are injured in the United States annually, accounting for roughly one in six hospital admissions. There are as many as 148,000 deaths related to trauma each year in the United States [1]. Unintentional injuries were the fifth leading cause of death in 2004 [2]. The fund of knowledge gained from experiences and research work has given victims of trauma significant potential for survival. This is particularly so when considering orthopedic trauma and the anesthetic management of its victims.

This chapter breaks the surface of the choppy waters of orthopedic trauma anesthesia. By exploring the patients that present, and the scenarios by which they may be married to trauma, as well as concepts related to their care, the anesthesia practitioner may gain a new perspective on the management of patients who have suffered acute orthopedic injuries.

EARLY FRACTURE FIXATION

When assessing a multiple-injury patient, attention to all systems is in high order. Although acute cardiopulmonary, visceral, and neurologic trauma take precedence, it is of extreme importance that orthopedic injuries are fully evaluated (see Chapters 13 and 15).

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Trauma Anesthesia , pp. 245 - 259
Publisher: Cambridge University Press
Print publication year: 2008

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  • Anesthetic Considerations for Orthopedic Trauma
    • By Robert M. Donatiello, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Andrew D. Rosenberg, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Charles E. Smith, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.019
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Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Anesthetic Considerations for Orthopedic Trauma
    • By Robert M. Donatiello, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Andrew D. Rosenberg, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Charles E. Smith, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.019
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Anesthetic Considerations for Orthopedic Trauma
    • By Robert M. Donatiello, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Andrew D. Rosenberg, Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York University Medical Center, New York, Charles E. Smith, Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.019
Available formats
×