Anaesthetic Management in THA

Total hip arthroplasty is one of the most frequent operations in hospitals of all types, which is performed predominantly in elderly people and has its own specifics. The algorithm focuses on the choice and method of anaesthesia. It points to a potentially fatal complication of the operation using cement implantation, the cement syndrome (BCIS) and offers a solution to this complication. Next it deals with the problem of perioperative blood loss, which needs to be quantified and subsequently rationally covered. The last part suggests the methods of post-operative pain treatment.

types of anaesthesia
rational hemotherapy
Published at: 1.7.2018


Jaroslav Krch, MD
Deputy Head of Department, Department of Anaesthesiology and Intensive Care, Liberec Regional Hospital, Liberec, Czech Republic

The algorithm of Anaesthesia for Total Hip Replacement describes in an interactive way options for anaesthesia in one of the most common orthopedic surgeries. Most patients undergoing this type of procedure are older with many complicating diseases and this algorithm draws attention to the relatively frequent and potentionally lethal complication called Bone Cement Implantation Syndrome (BCIS) and it identifies the risks of different types of anaesthesia and possible blood loss. It also offers rational choices of postoperative analgaesia. I believe that this algorithm is a  appropriate and instructive preparation form for postgradual education.


ALLMAN, Keith G. and WILSON, Iain H., eds. Oxford Handbook of Anaesthesia. 3. ed. Oxford: Oxford University Press, 2011. 1309 p. ISBN 9780199584048

OPPERER M., ANNINGER T., STUNDNER O., MEMTSOUDIS SG. Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review. World Journal of Orthopedics. 2014;5(3):336-343. doi:10.5312/wjo.v5.i3.336.

SO, Denise, Clara YU and M. A. DOANE. Bone Cement Implantation Syndrome: Tutorial 351. In: World Federation of Societies of Anaesthesiologists: Anaesthesia Tutorial of The Week [online]. 2017, 18. 4. 2017, s. 6 [cit. 2018-04-15]. Available at:

LEJDAROVÁ, Hana. Autologní odběry z pohledu účelné hemoterapie. In: 20. ročník Colours of Sepsis: Postkonferenční sborník [online]. Brno, 2018 [cit. 2018-05-14]. Available at:

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