CHOICE OF ANESTHETIC TECHNIQUE

In most cases, the choice of regional or general anesthesia in orthopedics depends on some or all of the following factors: patient's preference, state of health of the patient, expertise of the anesthesiologist, duration of the procedure, surgeon's preference, and practice pattern in the hospital. In general, most extremity procedures can be performed using regional anesthesia alone with light sedation. More complicated operations such as allograft replacements, major tumor surgery, reconstructive procedures, and repair of major trauma may be performed using general anesthesia alone. Alternatively, combined techniques using continuous regional anesthesia (e.g., lumbar epidural and axillary or femoral sheath techniques) supplemented with light general anesthesia using a laryngeal mask airway may be particularly useful, incorporating many of the benefits of regional anesthesia with a sedated patient and a secured airway.^[37]