**4. Venous thromboembolism**

Factors that increase the risk of thromboembolism are as follows:


Regional anesthesia reduces the incidence of thrombus formation and pulmonary embolism [6]. Davis et al. found that the deep vein thrombosis was 13% in spinal anesthesia, while 27% in general anesthesia [7]. Other approaches that reduce the risk of thromboembolism are the use of devices providing intermittent compression to legs and low-dose anticoagulant prophylaxis.

**4.1. Diagnosis**

• Chest X-ray

• Arterial blood gas analyses:

gradient increase (PO2

• Respiratory function tests:

• Ventilation with 100% O2

**5. Venous air embolism**

• Intravascular air volume

• Foramen ovale presence

• General health status

• The use of nitrogen protoxide

• Air inlet velocity

bilirubin are high.

**4.2. Treatment**

• Heparinization. • Inotropic agents. A-a).

.

lated. The best treatment is prophylaxis.

vein thrombosis and pulmonary embolism.

as compared with the atmospheric pressure.

Factors affecting air embolization are as follows:

• Major findings include hypoxemia, hypocapnia, respiratory alkalosis, and alveolar-arterial

Anesthesia Management in Total Hip Replacement http://dx.doi.org/10.5772/intechopen.76366 53

• Biochemical investigations: While CPK-MB, D-dimer, FDP, SGOT are normal, LDH and

• The physiological dead space (VD) and the tidal volumetric ratio (VD/VT) are increased.

• Surgical embolectomy is performed in the large embolus. The small embolus is anticoagu-

• Venous stasis should be avoided. For this purpose, the legs should be lifted up and early mobilization should be provided postoperatively. Advanced venous stasis causes deep

Low venous pressure and open ventilation are required for the air to enter the venous system

This most often occurs during the neurosurgery operations in a sitting position. In addition, poor surgical technique may increase the formation of air embolism.

• ECG

Pulmonary artery and its branches are obstructed by venous thrombus from systemic veins. There is a close relationship between pulmonary embolism (PE) and deep vein thrombosis (DVT).

DTV is responsible for 90% PE. In 1856, Wirchow described clinical triad about the reasons of venous thromboembolism:


Clinical impact of PE depends on several factors:


#### **4.1. Diagnosis**


**4. Venous thromboembolism**

52 Total Hip Replacement - An Overview

• Previous thromboembolism history

• Previous orthopedic operations

• Congestive heart failure

• Chronic lower limb laceration

• Oral contraceptive and estrogen • Unnecessary blood transfusions

• Advanced age

• Immobilization

• Obesity

prophylaxis.

• Venous stasis

venous thromboembolism:

• Hypercoagulopathy

• Local injury at vessel walls (intraluminal damage)

• Humoral factors released by serotonin and thromboxane A2 • Whether the patient has cardiopulmonary disorders or not

Clinical impact of PE depends on several factors:

• Width of obstructed vessels bed

• Patient's age and general health status

• Malignancy

Factors that increase the risk of thromboembolism are as follows:

Regional anesthesia reduces the incidence of thrombus formation and pulmonary embolism [6]. Davis et al. found that the deep vein thrombosis was 13% in spinal anesthesia, while 27% in general anesthesia [7]. Other approaches that reduce the risk of thromboembolism are the use of devices providing intermittent compression to legs and low-dose anticoagulant

Pulmonary artery and its branches are obstructed by venous thrombus from systemic veins. There is a close relationship between pulmonary embolism (PE) and deep vein thrombosis (DVT). DTV is responsible for 90% PE. In 1856, Wirchow described clinical triad about the reasons of

• Previous venous surgery and/or varicose surgery history


#### **4.2. Treatment**

