Perioperative and anesthetic management of patients with rheumatoid arthritis

Korean J Intern Med. 2022 Jul;37(4):732-739. doi: 10.3904/kjim.2021.555. Epub 2022 Jun 3.

Abstract

Our understanding and management of rheumatoid arthritis (RA) have greatly improved, but perioperative and anesthetic management remain challenging. RA is not limited to joints; systemic evaluation is thus required when planning perioperative management. Especially, careful airway evaluation is needed; management of airway-related arthritis is challenging. A multidisciplinary approach is essential to prevent complications without exacerbating RA disease activity. Guidelines published in 2017 are available for perioperative management of anti-rheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty. However, the guidelines focus only on anti- rheumatic medications, and do not consider all aspects of perioperative management (including anesthesia). Here, we discuss the perioperative and anesthetic management of patients with RA.

Keywords: Anesthesia; Arthritis, rheumatoid; Operation; Surgery.

Publication types

  • Review

MeSH terms

  • Anesthetics* / adverse effects
  • Antirheumatic Agents* / adverse effects
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / surgery
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Humans
  • Perioperative Care

Substances

  • Anesthetics
  • Antirheumatic Agents