Total hip replacement (THR)
Clinical Procedure
 
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Lateral cutaneous nerve and femoral nerve distribution.

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Obturator nerve distribution

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Antibiotics as per surgeons. Check medication chart for recently administered.

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May 18, 2011
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Deep vein thrombosis (DVT) risk high (give LMWH).
Chest 2008;133;71S-109 refl.in/u

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May 18, 2011
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lateral position

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Apr 06, 2012
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Spinal anaesthesia plus sedation is suitable for simple cases assuming no contraindications to neuraxial procedures.

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Nov 29, 2011
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Anterior lower limb sensory nerve distribution.

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Enquire about chronic pain medications such as opioids that may impact perioperative analgesia dosing requirements

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Fascia iliacus block results in 24hr morphine sparing. RCT 44 patients. refl.in/4f

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May 18, 2011
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GA plus regional (eg 3 in 1 block or epidural) for complicated cases (eg redos)

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Nov 29, 2011
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HIPAID study showed OR2.1 for perioperative bleeding (as secondary outcome) in hip arthroplasty with 2 weeks high dose ibuprofen

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May 18, 2011
refl.in/13
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Cementing can drop cardiac output by 30%, stroke volume by 44%, but no significant change in mean arterial pressure refl.in/21

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Aug 02, 2011
Same effect whether cement is used or not. It's the physical process of reaming and pressuring that releases fat and bone fragments. #ref
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Cementing increases risk of perioperative pulmonary embolism. OR 3.125 refl.in/22

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May 18, 2011
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Aggressive warming reduces blood loss during hip replacement. refl.in/23

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May 18, 2011
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Potential blood loss, moderate

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Mar 27, 2012
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Good summary of considerations refl.in/m6

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Posterior lower limb nerve distribution.

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Mar 12, 2012
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