Anesthesia and Pain Control for Osteointegration Implantation Into the Femur - Stage II Osteointegration Implant (OI) Skin Coupling Procedure
The success of our index case employing the use of the Osseointegration Implant (OI) is largely due to the coordinated efforts of the assembled team of medical professionals including nursing, surgeon and anesthesiologist. The anesthesetic methods and techniques were a central component of each of this patient’s surgeries. This is a report of the anesthetic methods employed in managing this patient’s pain before, during and after the implantation with the novel Longitude™ OI device.
The index patient was well know to the team having undergone multiple prior surgical procedures at our institution. This report will detail the anesthesia provided at the time of the transfemoral amputation, followed by the Stage I implantation of the Longitude™ OI device and finally concluded at the time of the stage II docking through the skin procedure. In each case the patient was offered neuraxial subarachnoid block  and declined.
Corning JL. Spinal anesthesia and local medications of the cord. N Y Med J. 1885;42:483.
Owens WD, Felts JA, Spitznagel EL Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978; 49: 239-43.
http://www.jointcommission.org/surgical_care_improvement_project/ accessed 12/21/2013.
http://www3.aaos.org/member/safety/guidelines.cfm accessed 12/21/2013.
http://en.wikipedia.org/wiki/Fentanyl accessed 12/21/2013.
http://www.drugs.com/pro/reglan.html accessed 12/21/2013.
http://en.wikipedia.org/wiki/Famotidine accessed 12/21/2013.
Asai T, Morris S. “The laryngeal mask airway: its features, effects and role”. Canadian Journal of Anesthesiology 2010; 41: 930-960.
http://en.wikipedia.org/wiki/Capnography accessed 12/21/2013.
http://en.wikipedia.org/wiki/Desflurane accessed 12/21/2013.
http://en.wikipedia.org/wiki/Ondansetron accessed 12/21/2013.
http://en.wikipedia.org/wiki/Midazolam accessed 12/21/2013.
Marhofer P, Harrop-Griffiths W, Willschke H, Kirchmair L. Fifteen years of ultrasound guidance in regional anesthesia: part 2 recent developments in block techniques. Br J Anaesth 23(3):337-41.
http://en.wikipedia.org/wiki/Lidocaine accessed 12/21/2013.
http://en.wikipedia.org/wiki/Bupivicaine accessed 12/21/2013.
http://en.wikipedia.org/wiki/Ketorolac accessed 12/21/2013.
http://en.wikipedia.org/wiki/Morphine accessed 12/21/2013.
http://en.wikipedia.org/wiki/Ropivicaine accessed 12/21/2013.
http://en.wikipedia.org/wiki/Propofol accessed 12/21/2013.
http://en.wikipedia.org/wiki/Patient-controlled_analgesia accessed 12/21/2013.
“Patient-controlled analgesia system (PCA)”. Clinical Reference Systems 10. McKesson Health Solutions. 2010.
Vallner JJ, Stewart JT, Kotzan JA, Kirsten EB, Honigberg IL. “Pharmacokinetics and bioavailability of hydromorphone following intravenous and oral administration to human subjects”. J Clin Pharmacol 21 (4): 152–6.
http://en.wikipedia.org/wiki/Hydrocodone accessed 12/21/2013.
http://en.wikipedia.org/wiki/Acetaminophen accessed 12/21/2013.
Copyright (c) 2014 Andrew Zak, MD, Ronald Hillock, MD
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