External iliac vein injury during total hip arthroplasty resulting in delayed shock

Abstract

We feel that CSA allows the use of initial small doses of local anaesthetics and that our results guide us in determining those doses for ropivacaine and levobupivacaine.

External iliac vein injury during total hip arthroplasty: a case report

“…But, we should aware that it is life threatening and could be hard to be noticed especially with lateral decubitus position [4,5,11]. However, despite the fatal risks, it still has not been emphasized enough in anesthetic literature.…”

“…Therefore, it is important for anesthesiologists to pay more attention on the complications related to it. EIV injury in THA is uncommon event even for vascular surgeons [4].…”

“…Although arterial injuries tend to show dramatic alterations of vital signs and faster blood pooling in operation field, which could be easier to be detected, venous injuries usually go unnoticed, regardless of the size of the laceration, and can lead to slow onset of shock [4,5,11]. Besides, as Doi et al reported [4], in lateral decubitus position, lower blood pressure may not be present or could be concealed than it actually is, which make it even more difficult to detect the presence of EIV injury during THA.…”

Complications Following Total Hip Arthroplasty

“…Risk factors include revision surgery, previous vascular injury or surgery and pre-existing atherosclerosis [137]. The majority of vascular injuries are arterial but venous injury has been described [138]. Venous injuries however may be under diagnosed as they may run a relatively benign course remaining undetected.…”

Vascular Injury in Total Hip Replacement: Management and Prevention

“…Vessel injuries giving immediate symptoms of total hip replacement are the severe hemorrhage. The most common ischemic symptoms in the delayed postoperative period include pain, the decrease of hemoglobin, swelling, reduced blood pressure and hypovolemic shock [1,2,4,6,10,11,22,23]. Other presenting signs and symptoms of vessel injury in revision surgeries include excessive bleeding, loss of pulse and instability during extraction of hip prosthesis [19].…”