Anesthesia Management in Total Hip Replacement

Hip fracture is usually seen in advanced age. Due to the presence of metastases in elderly patients, the density of bones decreases, and the possibility of fracture increases. Cytokines, released from osteoclasts resulting in post-bony destruction, cause pain by activating pain receptors; hence, pain-related motion restriction may occur. Bone marrow suppression and medulla spinalis pressure may be seen in metastatic bone tumors. Three major complications can be observed in hip fracture operations: (1) perioperative bleeding, (2) bone cementum implantation syndrome and (3) thromboembolism. These indicate superiority of general anesthesia: 1 –controlled respiration. 2 –Invasive interventions to be performed during shock treatment can be made more easily and smoothly. 3 – The safest way to ensure that patients remain immobilized on the operating table. 4 – Hemodynamic parameters can be better controlled. Regional anesthesia has benefits such as allowing early mobilization and postoperative pain control and few complications such as hypoxia, deep vein thrombosis and consciousness blurring. Various regional anesthesia methods such as spinal, epidural, combined spinal-epidural and peripheral nerve blocks are applied. The knowledge and experience of the anesthetist, the general condition and the mental state of the patient, the skill of the surgeon and the type of surgery determine the type of the anesthesia