Anesthesiology and Orthopaedics team-up to decrease risks, and improve comfort for joint replacement patients
In the last few years, the anesthetic choice for hip and knee replacement surgery has been a hot topic nationally. Even before the opening of our Lafayette General Orthopaedic Hospital, novel strategies had been actively pursued by our physicians to enhance the experience of these elective, and historically painful, procedures. Dr. Scott Yerger, orthopaedic surgeon, and Dr. Julie Broussard, an anesthesiologist, have championed the development of the processes and protocols that have driven the treatment decisions currently used for elective joint replacements.
Up until 10 years ago, the majority of joint replacement surgeries were performed under general anesthesia, which requires the patient to be heavily sedated and use a ventilator during surgery. The cutting-edge trend is an anesthetic geared toward less sedation, preemptive pain control, mobilization the same day as surgery and overall a dramatically faster and streamlined recovery process. One of the first service lines to protocolize a more modern anesthesia technique termed ERAS, was orthopaedic surgery for total joint procedures. ERAS refers to Enhanced Recovery after Surgery and is a multifaceted approach to lessen the use of opioids and align patient expectations about pain through nonnarcotic preemptive analgesia and education.
The use of regional anesthesia including spinal anesthesia and nerve blocks, allows for less sedation intraoperatively and dramatically reduces sedative-induced side effects. The patients wake up from their hip or knee procedure still numb from the regional anesthetic and more alert than with the previously used general anesthesia and opioid technique. Many more of these procedures are now being performed without the use of indwelling foley catheters, decreasing the risk of hospital acquired urinary tract infections. Regional techniques also have the added benefit in joint replacement procedures of lessening intraoperative blood loss, less renal and pulmonary complications and lower infection rates.
The anesthesiologists and orthopaedic surgeons of Lafayette General Orthopaedic Hospital are constantly challenging the historical practices and updating techniques and protocols to ensure the safest and most successful joint operations while providing the most comfortable experience possible. Nearly all of the elective hip and knee replacement procedures receive an ERAS protocol and a spinal regional anesthetic technique.
The patient outcomes and experience are drastically different than in years past. The smiles on our patients’ faces when they take their first steps the afternoon of their surgery is proof enough that what we are doing is right.