Perioperative solutions for rapid recovery joint arthroplasty: Get ahead and stay ahead

Peter K. Sculco, Mark Pagnano

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Rapid recovery after total joint arthroplasty requires patients to get ahead and stay ahead or the four impediments to early rehabilitation and discharge: volume depletion, blood loss, pain, and nausea. Adequate volume resuscitation starts before entering the operating room and focuses on intravenous fluids rather than red blood cell transfusion. Tranexamic acid limits blood loss and reduces the need for most other blood management systems. Rapid recovery pain management focuses on minimizing parenteral opioids. A short-acting spinal with a peri-articular local anesthetic injection is reliable, reproducible, and safe. Patients at risk for post-operative nausea are treated with anti-emetic medications and perioperative dexamethasone. These interventions reflect a transition from the sick-patient model to the well-patient model and make rapid recovery joint arthroplasty a reality in 2015.

Original languageEnglish (US)
Pages (from-to)518-520
Number of pages3
JournalJournal of Arthroplasty
Volume30
Issue number4
DOIs
StatePublished - Apr 1 2015

Fingerprint

Arthroplasty
Joints
Nausea
Tranexamic Acid
Patient Transfer
Erythrocyte Transfusion
Antiemetics
Operating Rooms
Pain Management
Local Anesthetics
Blood Volume
Resuscitation
Dexamethasone
Opioid Analgesics
Rehabilitation
Pain
Injections

Keywords

  • Blood loss
  • Pain control
  • Perioperative management
  • Rapid recovery
  • Total joint arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Perioperative solutions for rapid recovery joint arthroplasty : Get ahead and stay ahead. / Sculco, Peter K.; Pagnano, Mark.

In: Journal of Arthroplasty, Vol. 30, No. 4, 01.04.2015, p. 518-520.

Research output: Contribution to journalArticle

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