KEY POINTS

1. There are anesthetic implications for debilitating rheumatologic disease, including rheumatoid arthritis and ankylosing spondylitis.
2. The anesthesiologist must consider the unique considerations for the proper positioning of orthopedic patients.
3. The benefits of hypotensive epidural anesthesia as a technique include limiting the need for homologous blood transfusion during total-hip arthroplasty.
4. Cement fixation, femur reaming, insertion of cemented femoral components, and relocation of the hip joint in total-hip arthroplasty have physiologic implications.
5. Reduced mortality rates are associated with femoral neck fractures when managed with combined neuraxial and peripheral nerve blocks.
6. Tourniquet use and effective postoperative regional analgesia during total-knee arthroplasty have important physiologic implications.
7. Airway management, positioning, and fluid replacement are important during cervical spinal surgery.
8. The anesthesiologists must consider the medical conditions associated with scoliosis and the specific monitoring techniques required to maintain spinal cord and nerve root function during spinal surgery.
9. Major spinal surgery may cause visual loss.
10. Peripheral nerve blocks can serve as the sole anesthetic or be used for prolonged postoperative analgesia.
11. The anesthesiologist must recognize anesthetic complications specific to orthopedic surgical procedures.