Introduction

Perioperative management of the orthopedic patient depends on the age group involved, the presence of concurrent systemic disease, and the planned surgical procedure. Certain congenital and/or neuromuscular-skeletal problems present in childhood, and these patients may require multiple surgical procedures as they grow older. Patients with major trauma may have multisystem involvement. Elderly patients commonly have intercurrent cardiovascular disease or other conditions, with the main cause of mortality following anesthesia and surgery being due to cardiac disease; outcome is not influenced by choice of either a regional or general anesthetic technique.

In many cases the need for postoperative intensive or high-dependency care can be anticipated and surgery planned accordingly. However, there are a number of patients in whom unexpected complications arise perioperatively, related to the nature of the surgery involved, with often massive blood loss, the use of large quantities of acrylic bone cement, and the occurrence of fat, air, and venous embolism.

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