Anesthetic Management of Patients With Chronic Respiratory Diseases For Major Orthopedic Surgery

Abstract

oint replacement surgery is a common and effective procedure for the relief of disability due to severe joint pain and loss of function. The most common joints replaced are the hip and knee, but with advances in technology and surgical techniques the range of joints that may be replaced is increasing. Most patients for joint replacement surgery are elderly, and commonly have associated problems such as chronic pulmonary diseases. Chronic respiratory diseases (CRDs) are diseases of the airways and other structures of the lung. They are classified as obstructive lung diseases or restrictive lung diseases. Obstructive lung diseases include conditions that make it hard to exhale all the air in the lungs as in COPD, asthma, bronchiectasis and cystic fibrosis. Meanwhile, People with restrictive lung disease have difficulty fully expanding their lungs with air and the cause may be of intrinsic cause like in interstitial lung fibrosis or extrinsic like in diseases of the pleura. Obstructive and restrictive lung diseases share the same main symptom: shortness of breath with exertion. They are identified using pulmonary function tests, imaging (x-ray film, CT scan) and bronchoscopy. For safe conduction of anesthesia, it is important to assess the risk for perioperative complications of chronic respiratory disease patients and major joint replacement surgeries, the method of choice for anesthetic technique and the specific advantages