**12. Pain education**

Preoperative training including surgical procedure and rehabilitation protocol, informing the prospective benefits of the procedure, postoperative pain level and pain management techniques (intravenous, epidural patient-controlled analgesia), is beneficial to reduce patient anxieties, increase patient satisfaction, and reduce rehabilitation and hospital stay. Pre-emptive administration of opioid analgesics, NSAII and COX-2 inhibitors can provide effective postoperative analgesia. However, it should be considered that opioid use is associated with increased postoperative nausea and vomiting risk. Pre-emptive epidural analgesia with an epidural catheter prior to arthroplasty can provide postoperative pain control at a significant level [10].

• With controlled breathing, it may be possible to obtain the patient's alveolar oxygen pres-

Anesthesia Management in Total Hip Replacement http://dx.doi.org/10.5772/intechopen.76366 59

• Invasive interventions to be done for the treatment of shock and monitoring of unconscious

• It is the safest way for patients with restless and agitation due to shock and pain due to

• General anesthesia has some advantages (better control of hemodynamic parameters, giv-

• Induction under appropriate monitoring conditions following a good pre-oxygenation to

• Hypnotics, narcotic agents and inhalation agents with balanced anesthesia usually mini-

Given that the vast majority of hip fracture surgeries are performed on elderly individuals, general anesthesia guidelines should be followed in geriatric patients. At first, the premedication to which the respiratory tract may be depressed should be avoided or the dose should

When performing volume replacement, the cardiac load should be avoided and the mean arterial pressure should be preserved. Respiratory depression can be avoided by minimizing the opioid dose. The inotropic medicines can be necessary to treat hypotension. The preserve

We must make sure that the neuromuscular block is completely turned. For postoperative analgesia, regional anesthesia techniques should be used and the dose should be adjusted.

There is a long history for epidural and spinal block interventions and the use of these interventions for pain relief. Both techniques are widely used around the world. They have some advantages such as regional anesthesia interventions, early mobilization, postoperative pain relief and reduced risk of DVT, hypoxia and conscious problems [12]. There are a number of studies in geriatric patients that indicate the superiority of regional anesthesia in hip fracture

en oxygen with higher concentration compared to regional anesthesia) [11].

• It should be given attention for the position of the patient during anesthesia.

sure to the levels that meet the oxygen needs of the tissues.

patient can be completed more easily and free of problems.

trauma to remain immobilized on the operating table.

mize the potential problems in a perioperative period.

*14.1.1. The general anesthesia management in elderly patients*

of renal function should also be supplied.

**14.2. Regional anesthesia**

Advantages of spinal anesthesia:

Important points in general anesthesia:

reduce hypoxemia risk.

be reduced.

operations.

• Firstly, enough volume should be replaced.
