Alturki Abdullah A, Aljaafri Ziad A, Alshabraqi Halah, Hassan Ibrahim, Alturki Ahmad, Alhandi Ali A
Department of Orthopedics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, SAU.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Cureus. 2024 Feb 29;16(2):e55269. doi: 10.7759/cureus.55269. eCollection 2024 Feb.
Total knee arthroplasty (TKA) is a commonly performed surgery for individuals experiencing advanced knee osteoarthritis. Patients undergoing TKA can present with a variety of comorbidities, ranging from the absence of chronic illnesses to the presence of multiple health conditions. The complexity of these comorbidities can pose challenges in carrying out the desired procedure due to the elevated risk profile; this limits the anesthesia modalities that the physician can utilize. Careful consideration of patients' overall health status and personalized anesthesia approaches are crucial to ensure optimal outcomes in this diverse patient population. This case involves an eighty-year-old male with a history of multiple comorbidities who underwent a left TKA. The patient presented a high-risk profile during evaluation, classified as American Society of Anesthesiology (ASA) class IV, which made general and neuraxial anesthesia unfavorable due to high risks. Regional anesthesia was utilized as the sole modality of anesthesia and was successful. This demonstrates that regional anesthesia is a viable option when attending to patients with high risks associated with other anesthesia modalities.
全膝关节置换术（TKA）是针对患有晚期膝关节骨关节炎的患者常施行的手术。接受TKA的患者可能伴有多种合并症，从无慢性疾病到存在多种健康问题不等。由于风险较高，这些合并症的复杂性会给实施预期手术带来挑战；这限制了医生可采用的麻醉方式。仔细考虑患者的整体健康状况和个性化麻醉方法对于确保这一多样化患者群体获得最佳治疗效果至关重要。本病例涉及一名患有多种合并症的80岁男性，他接受了左膝TKA手术。该患者在评估期间呈现出高风险特征，被归类为美国麻醉医师协会（ASA）IV级，这使得全身麻醉和神经轴索麻醉因风险过高而不宜采用。区域麻醉被用作唯一的麻醉方式且取得了成功。这表明，在处理与其他麻醉方式相关的高风险患者时，区域麻醉是一种可行的选择。
