PERIOPERATIVE MEDICINE / ORIGINAL ARTICLE
Standards of anaesthesia for total knee and hip arthroplasty procedures. A survey-based study.
Part II: Anaesthetic management
More details
Hide details
1
Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
2
Department of Intensive Care and Anaesthesiology, 5th Military Hospital with Polyclinic in Krakow, Poland
3
Department of Anaesthesiology and Intensive Care, Medical University of Gdansk, Poland
4
Department of Anaesthesiology and Intensive Care, Ludwik Rydygier Specialist Hospital in Krakow, Poland
5
Orthopaedic and Trauma Surgery Clinic, 5th Military Hospital with Polyclinic (Independent Public Health Care Institution) in Krakow, Poland
6
Department of Anaesthesiology and Intensive Care, Regional Hospital in Gorzow Wielkopolski, Poland
7
Fatebenefratelli Medical Center, Wroclaw, Poland
Submission date: 2024-09-12
Final revision date: 2025-01-05
Acceptance date: 2025-01-16
Corresponding author
Wojciech Szczeklik
Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Cracow, Poland
Anaesthesiol Intensive Ther 2025;(1):4-10
KEYWORDS
TOPICS
ABSTRACT
Background:
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures are being performed more and more frequently. Since these procedures carry an indirect
risk of perioperative complications, practice standards are warranted to minimise
the incidence of adverse events. A survey-based study was carried out to identify
the patterns of anaesthesiology practice in Polish hospitals.
Methods:
A survey was conducted among anaesthetists nationwide using the LimeSurvey application. The questions concerned the intraoperative and postoperative periods
and focused mainly on the determination of anaesthetic methods for total joint
replacement (TJR) procedures and postoperative pain management. Questionnaires
included both single and multiple-choice questions.
Results:
A total of 258 responses from anaesthetists from 112 Polish healthcare institutions
were included in the analysis. The subarachnoid block is performed by 86.0%
of anaesthetists for TKA and 88.0% for THA. For TKA procedures, 30.6% of respondents
state that they do not perform any additional peripheral block, and for THA this percentage is 44.6%. The most commonly performed peripheral nerve block for TKA is
the femoral nerve block (46.5%) and for THA it is the fascia iliaca compartment block
(42.6%). More than 90% of anaesthetists report routine use of systemic analgesics in TJR,
with opioid use exceeding 80%.
Conclusions:
The study showed that anaesthetic perioperative care in Poland requires several modifications to better adhere to clinical standards. The most important issues include increasing the number of regional blocks, decreasing the use of opioid analgesics for post-operative pain management and introducing perioperative troponin screening.