[Perioperative management of patients during general endoprosthethic operations on the knee joint (a review of literature)].
Arthrosis deformans of the knee joint (gonarthrosis) is a common disease accompanied by pain syndrome and disability. Medical treatment of the disease ensures only a temporary analgesic effect and fails to restore the range of motion in the legs. General endoprosthetic operations on the knee joint can significantly improve the results of treatment, alleviate pain, and restore the patients' working capacity. Most patients undergoing endoprosthetic repair of the knee joint are elderly and senile, who have concomitant multiple organ somatic pathology. Comorbidity, old age, the specific features and traumaticity of a surgical intervention make high requirements for anesthesic maintenance at surgery and for stability of hemodynamic parameters in the perioperative period, and adequate analgesia in the postoperative period. Different approaches to adequate anesthesia are considered in both intra- and postoperative period. Numerous references lead to the conclusion that many widely used anesthetic procedures (general inhalational and intravenous anesthesia, high-conduction anesthesia, etc.) are incompletely adequate during a general endoprosthetic repair of the knee joint. A number of authors state that spinal or combined spinal epidural anesthesia is the most adequate methods of intra- and postoperative anesthesia at general endoprosthetic repair of the knee joint.
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D000758:Anesthesia; D019645:Arthroplasty, Replacement, Knee; D010149:Postoperative Pain / Q000188:drug therapy; D019990:Perioperative Care / Q000379:methods*