Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study
Spinal anaesthesia is an established component of perioperative management for fast-track lower limbs arthroplasty. Short-acting local anaesthetics may present an interesting option for primary non-complicated knee (TKA) and hip (THA) arthroplasty. We describe the perioperative outcomes in patients...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5771 |
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| author | Khaleifah Alhefeiti Ana-Maria Patrascu Sebastien Lustig Frederic Aubrun Mikhail Dziadzko |
| author_facet | Khaleifah Alhefeiti Ana-Maria Patrascu Sebastien Lustig Frederic Aubrun Mikhail Dziadzko |
| author_sort | Khaleifah Alhefeiti |
| collection | DOAJ |
| description | Spinal anaesthesia is an established component of perioperative management for fast-track lower limbs arthroplasty. Short-acting local anaesthetics may present an interesting option for primary non-complicated knee (TKA) and hip (THA) arthroplasty. We describe the perioperative outcomes in patients operated under fixed 50 mg spinal chloroprocaine for total hip and knee replacement. In this retrospective case series study, 65 patients were analysed (median age 65 years, 55% females, benefit from THA (<i>n</i> = 31), TKA (<i>n</i> = 25), and unicompartmental knee arthroplasty (<i>n</i> = 9)). In all cases, anaesthesia duration (87 min) was sufficient for successful surgery (52 min). Up to 45% of patients (THA and less in TKA) developed postoperative pain in the post-anaesthesia care unit (PACU), requiring intravenous morphine titration (up to 7.5 mg). One patient developed severe breakthrough pain requiring advanced regional analgesia. The median PACU stay was up to 97 min (less in TKA), and the incidence of nausea and urinary retention was low. All patients were able to start physical therapy on the same day of surgery. These findings encourage the use of a short-acting agent for spinal anaesthesia in patients with primary non-complicated arthroplasty; however, the relay analgesia should be systematically implemented to avoid breakthrough pain in PACU. |
| first_indexed | 2024-03-09T21:34:01Z |
| format | Article |
| id | doaj.art-123a409f77834bd29ec13ddda70e59dc |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:34:01Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-123a409f77834bd29ec13ddda70e59dc2023-11-23T20:48:28ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119577110.3390/jcm11195771Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series StudyKhaleifah Alhefeiti0Ana-Maria Patrascu1Sebastien Lustig2Frederic Aubrun3Mikhail Dziadzko4Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, F-69004 Lyon, FranceDépartement d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, F-69004 Lyon, FranceDépartement de Chirurgie Orthopédique et Médecine de Sport, Centre d’Excellence FIFA Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, F-69004 Lyon, FranceDépartement d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, F-69004 Lyon, FranceDépartement d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, F-69004 Lyon, FranceSpinal anaesthesia is an established component of perioperative management for fast-track lower limbs arthroplasty. Short-acting local anaesthetics may present an interesting option for primary non-complicated knee (TKA) and hip (THA) arthroplasty. We describe the perioperative outcomes in patients operated under fixed 50 mg spinal chloroprocaine for total hip and knee replacement. In this retrospective case series study, 65 patients were analysed (median age 65 years, 55% females, benefit from THA (<i>n</i> = 31), TKA (<i>n</i> = 25), and unicompartmental knee arthroplasty (<i>n</i> = 9)). In all cases, anaesthesia duration (87 min) was sufficient for successful surgery (52 min). Up to 45% of patients (THA and less in TKA) developed postoperative pain in the post-anaesthesia care unit (PACU), requiring intravenous morphine titration (up to 7.5 mg). One patient developed severe breakthrough pain requiring advanced regional analgesia. The median PACU stay was up to 97 min (less in TKA), and the incidence of nausea and urinary retention was low. All patients were able to start physical therapy on the same day of surgery. These findings encourage the use of a short-acting agent for spinal anaesthesia in patients with primary non-complicated arthroplasty; however, the relay analgesia should be systematically implemented to avoid breakthrough pain in PACU.https://www.mdpi.com/2077-0383/11/19/5771arthroplastychloroprocaineperioperative outcomespinal anaesthesia |
| spellingShingle | Khaleifah Alhefeiti Ana-Maria Patrascu Sebastien Lustig Frederic Aubrun Mikhail Dziadzko Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study Journal of Clinical Medicine arthroplasty chloroprocaine perioperative outcome spinal anaesthesia |
| title | Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study |
| title_full | Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study |
| title_fullStr | Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study |
| title_full_unstemmed | Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study |
| title_short | Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty—Consecutive Case Series Study |
| title_sort | perioperative outcomes in patients who received spinal chloroprocaine for total hip or knee arthroplasty consecutive case series study |
| topic | arthroplasty chloroprocaine perioperative outcome spinal anaesthesia |
| url | https://www.mdpi.com/2077-0383/11/19/5771 |
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