Anesthetic Management in ERAS Protocols for Total Knee and Total Hip Arthroplasty: An Integrative Review

2.50
Hdl Handle:
http://hdl.handle.net/10755/621690
Category:
Full-text
Format:
Text-based Document
Type:
Other Graduate Paper
Level of Evidence:
Literature Review
Research Approach:
N/A
Title:
Anesthetic Management in ERAS Protocols for Total Knee and Total Hip Arthroplasty: An Integrative Review
Author(s):
Oseka, Laura
Additional Author Information:
Laura Oseka, DNAP, CRNA laura.oseka@bryanhealthcollege.edu
Advisors:
Pecka, Shannon
Degree:
Doctoral – Other
Degree Year:
2017
Grantor:
Bryan College of Health Sciences
Abstract:

Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic and analgesic recommendations for inclusion in an enhanced recovery after surgery (ERAS) protocol for patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).

Methods: Articles published between 2006 and December 2016 were critically appraised for validity, reliability, and rigor of study.

Results: The administration of non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, gabapentinoids, and steroids result in shorter hospital length of stay (LOS) and decreased postoperative pain and opioid consumption. A spinal anesthetic block provides benefits over general anesthesia, such as decreased 30-day mortality rates, hospital LOS, blood loss, and complications in the hospital. The use of peripheral nerve blocks result in lower pain scores, decreased opioid consumption, fewer complications, and shorter hospital LOS.

Conclusion: Perioperative anesthetic management in ERAS protocols for TKA and THA patients should include the administration of acetaminophen, NSAIDs, gabapentinoids, and steroids. Preferred intraoperative anesthetic management in ERAS protocols should consist of spinal anesthesia with light sedation. Postoperative pain should be managed with peripheral nerve blocks such as adductor canal block or femoral nerve block supplemented with sciatic nerve block or local infiltrated anesthesia.

Keywords:
anesthetic management; enhanced recovery after surgery protocol; total knee arthroplasty; total hip arthroplasty
CINAHL Headings:
Anesthesia--Methods; Anesthesia; Perioperative Care; Pain--Therapy; Postoperative Pain; Postoperative Pain--Therapy; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Protocols; Recovery
Repository Posting Date:
2017-07-06T16:28:52Z
Date of Publication:
2017-07-06

Full metadata record

DC FieldValue Language
dc.contributor.advisorPecka, Shannonen
dc.contributor.authorOseka, Lauraen
dc.date.accessioned2017-07-06T16:28:52Z-
dc.date.available2017-07-06T16:28:52Z-
dc.date.issued2017-07-06-
dc.identifier.urihttp://hdl.handle.net/10755/621690-
dc.description.abstract<p>Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic and analgesic recommendations for inclusion in an enhanced recovery after surgery (ERAS) protocol for patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).</p> <p>Methods: Articles published between 2006 and December 2016 were critically appraised for validity, reliability, and rigor of study.</p> <p>Results: The administration of non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, gabapentinoids, and steroids result in shorter hospital length of stay (LOS) and decreased postoperative pain and opioid consumption. A spinal anesthetic block provides benefits over general anesthesia, such as decreased 30-day mortality rates, hospital LOS, blood loss, and complications in the hospital. The use of peripheral nerve blocks result in lower pain scores, decreased opioid consumption, fewer complications, and shorter hospital LOS.</p> <p>Conclusion: Perioperative anesthetic management in ERAS protocols for TKA and THA patients should include the administration of acetaminophen, NSAIDs, gabapentinoids, and steroids. Preferred intraoperative anesthetic management in ERAS protocols should consist of spinal anesthesia with light sedation. Postoperative pain should be managed with peripheral nerve blocks such as adductor canal block or femoral nerve block supplemented with sciatic nerve block or local infiltrated anesthesia.</p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectanesthetic managementen
dc.subjectenhanced recovery after surgery protocolen
dc.subjecttotal knee arthroplastyen
dc.subjecttotal hip arthroplastyen
dc.titleAnesthetic Management in ERAS Protocols for Total Knee and Total Hip Arthroplasty: An Integrative Reviewen_US
dc.typeOther Graduate Paperen
thesis.degree.grantorBryan College of Health Sciencesen
thesis.degree.levelDoctoral – Otheren
dc.primary-author.detailsLaura Oseka, DNAP, CRNA laura.oseka@bryanhealthcollege.eduen
thesis.degree.year2017en
dc.type.categoryFull-texten
dc.evidence.levelLiterature Reviewen
dc.research.approachN/Aen
dc.subject.cinahlAnesthesia--Methodsen
dc.subject.cinahlAnesthesiaen
dc.subject.cinahlPerioperative Careen
dc.subject.cinahlPain--Therapyen
dc.subject.cinahlPostoperative Painen
dc.subject.cinahlPostoperative Pain--Therapyen
dc.subject.cinahlArthroplasty, Replacement, Hipen
dc.subject.cinahlArthroplasty, Replacement, Kneeen
dc.subject.cinahlProtocolsen
dc.subject.cinahlRecoveryen
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