Orthopedic Anesthesia

Question 1

What are the risk factors for posoperative ischemic optic neuropathy after prone spinal surgery?

Answer 1

obesity

old age

male gender

longer procedure time

larger blood loss

larger crystalloid resuscitation

Wilson frame

Question 2

What are the time course and associated finding in fat embolism syndrome following pelvic and long bone trauma?

Answer 2

typically presents 1-3 days post-operatively

findings include respiratory failure, right heart failure, altered mental status, coagulopathy, and pettichiae (uncommon, but pathognomonic)

Question 3

What is bone cement implantation syndrome?

Answer 3

methylmethacrylate bone cement expands in the bone shaft leading to high intramedullary pressures and causing fat embolism syndrome

Question 4

What problems are associated with long tourniquet times?

Answer 4

neurologic injury (if > 2 h)

rhabdomyolysis

compartment syndrome from reperfusion injury

Question 5

What are the advantages of neuraxial anesthesia over general anesthesia for knee and hip replacement?

Answer 5

decreased post-op pain

decreased intra-op blood loss

decreased risk of DVT

decreased post-op nausea and vomiting