Anaesthetic care of patients undergoing primary hip and knee arthroplasty: evolution of views

Operations of total hip arthroplasty (THA) and knee joints (TKA) are among the most frequently performed surgical interventions. At the same time, there is still no consensus regarding the choice of the optimal method of anesthesia for these operations. The review analyzes the approaches to the anesthetic provision of THA and TKA in different countries and different clinics of the same country. The tendencies of a gradual increase in the share of neuraxial anesthesia techniques in the structure of anesthesia for THA and TKA are presented. Based on a number of large population studies, an analysis of the effect of the anesthesia method on the early postoperative period and the results of surgical treatment in general is given. The positive role of epidural and spinal anesthesia, in comparison with general anesthesia, in the complex of anesthetic management of operations on the joints of the lower extremities has been shown.