Recently, with the joint efforts of the Department of Orthopedics and the Department of Anesthesiology of Fengkai County People's Hospital, Meng Fangang, an orthopedic sports medicine surgeon at the First Affiliated Hospital of Sun Yat-sen University, and Yang Xiaoyu, an anesthesiology expert, successfully performed an arthroscopic dissociation surgery on a 70-year-old man with heart failure and atrial fibrillation.
The patient is a 70-year-old mother-in-law who suffered from left knee pain for several months due to loose bodies in the joint. Elderly people who have suffered from heart failure and atrial fibrillation for many years and take long-term oral anticoagulant drugs are at higher risk. For this patient, the anesthesia was more difficult than the surgery itself. Yang Xiaoyu and Meng Fangang carefully examined the patient and read the films, combined with the cardiac color ultrasound and electrocardiogram results, and discussed with the general department doctors to formulate a detailed personalized anesthesia and treatment plan for the patient.
Older patients have poor tolerance to anesthesia and surgery due to their age, poor cardiopulmonary function and other physical functions. If the anesthesia plan is inappropriate, complications can easily occur. Yang Xiaoyu introduced: "The anesthesia management of elderly surgical patients has always been a difficulty in the anesthesiology discipline."
Yang Xiaoyu also said, "Such patients should pay attention to controlling their heart rate during the perioperative period and preventing thrombosis. Anesthesia must be done preoperative preparations , and related examinations such as cardiac color Doppler ultrasound and assessment of cardiac function need to be completed first, and the heart rate should be controlled below 110 beats/min. The anesthesia method can be intracanal anesthesia or neuraxial anesthesia. Choose general anesthesia , just pay attention to monitoring and controlling blood pressure heart rate. This type of surgery has little blood loss, so excessive fluid replenishment should be avoided. Anticoagulants can be used promptly after surgery to prevent blood clots. "
With close cooperation between the anesthesiology department and the orthopedics department, the medical team used arthroscopy to successfully remove the loose body from the knee joint using arthroscopy, which solved the patient's long-standing walking pain and interlocking knee joint symptoms. This is also a new achievement of the hospital's disciplinary linkage with the support of , Zhongshan First Hospital, and lays a solid foundation for the development of complex surgeries in the future.
Meng Fangang introduced that loose bodies in the knee joint are loose cartilage, meniscus or other tissues that appear in the knee joint. These shed objects can wander in the knee joint. Loose bodies in the knee joint are generally caused by trauma, joint degeneration and other reasons. He also said that usually, patients will show pain in the knee joint, knee joint locking, knee joint snapping during activities, and in severe cases, there may even be effusion, swelling and other symptoms. During treatment, loose bodies usually need to be removed through minimally invasive surgery under knee arthroscopy .
[Southern + reporter] Liu Liang
[Correspondent] Xu Haohuan
[Author] Liu Liang
[Source] Southern Newspaper Media Group Southern + Client
