Perioperative Management of Patients with Rheumatic Disease Brian F. Mandell Editor Perioperative Management of Patients with Rheumatic Disease Editor Brian F. Mandell, M.D., Ph.D Department of Rheumatologic and Immunologic Disease Cleveland Clinic Cleveland, OH, USA ISBN 978-1-4614-2202-0 ISBN 978-1-4614-2203-7 (eBook) DOI 10.1007/978-1-4614-2203-7 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2012940198 © Springer Science+Business Media, LLC 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Preface Perioperative care of the patient with a multisystem in fl ammatory (rheumatic) disease has become increasingly complex. Patients are often receiving mul- tiple medications, are at least intermittently profoundly immunosuppressed, and may have signi fi cant organ dysfunction. At the same time, perioperative medicine has evolved almost into its own subspecialty. Physicians who have expertise in managing patients with rheumatic disease infrequently spend signi fi cant amount of their time also managing patients undergoing surgical procedures, and the reverse is equally true. Hence, there is the need for a reference source offering some guidance on the management of these patients in the perioperative setting. Despite the burgeoning literature on the medical management of the surgi- cal patient, scant data have been generated regarding patients with complex rheumatic disease. Prospective trials do not generally include these patients, and retrospective reviews are few and relatively small. Thus, textbooks and review articles in this clinical area have been by necessity limited to expert opinion, and none have extensively focused on the special clinical problems that are emphasized in this text. The authors of this text have collectively done yeoman’s work in putting together a set of unique chapters which I hope that you will fi nd both readable and useful. Many of the authors when approached to write these chapters voiced concern that there were little data, let alone strong evidence, to dictate their management suggestions. My standard reply was, “Exactly; that’s why this book should be written, and why you should provide your experience based opinion.” For many of the clinical scenarios discussed in this book, it is not likely that there will ever be strong evidence to guide us in making the decisions that must, nonetheless, be made. Evidence is referenced and commented upon when available, but as editor, I pushed the authors to provide you with their best opinion (based on their extensive personal experience that few clinicians have had the opportunity to share) when high-level evidence does not exist. Our goal is to provide at least a semipaved path for rheumatologists, who infrequently manage surgical problems, and medical consultants, who only seldom encounter patients with these rheumatic diseases, to tread as they care for these patients in the periop- erative period. We all recognize that “truth” in medicine is a fl uid concept, but at the time of this writing, these contents re fl ect the best we can do. v vi Preface On a personal note, I warmly acknowledge my former partners at the University of Pennsylvania, Michael Baime and Eliot Nierman, superb gen- eral internists, who kindled my interest in medical consultation and tolerated and supported my efforts as a rheumatologist trying to learn the nuances of perioperative medicine. Cleveland, OH, USA Brian F. Mandell Contents 1 Anesthetic Issues for Orthopedic Surgery in Patients with Rheumatoid Diseases ............................................................ 1 John E. Tetzlaff 2 Perioperative Pain Management and Orthopedic Surgery ............................................................... 23 John E. Tetzlaff 3 Autologous Blood Transfusion ..................................................... 41 Ajay Kumar 4 Venous Thromboembolism Prophylaxis in the Patient with Rheumatic Diseases Undergoing Orthopedic Surgery ...................................................................... 45 Taki Galanis and Geno J. Merli 5 Preoperative Cardiovascular Risk Assessment .......................... 57 C. Ronald MacKenzie and Michael K. Urban 6 Management of Medications in Patients with Rheumatic Diseases During the Perioperative Period ................................... 71 Gregory C. Gardner 7 Prophylactic Antibiotic Use in Patients with Rheumatic Diseases .............................................................. 87 Lucileia Teixeira 8 Perioperative Management of Antiphospholipid Antibody Positive Patients During Noncardiac Surgeries .................................................................... 91 Katherine H. Saunders and Doruk Erkan 9 Perioperative Management of Anticoagulation in the Patient with the Antiphospholipid Syndrome in Cardiac Surgery and Cardiac Interventions .......................... 109 John R. Bartholomew vii viii Contents 10 Perioperative Management of the Patient with Immune Thrombocytopenic Purpura De Novo and the Thrombocytopenia of Antiphospholipid Antibody Syndrome ................................... 129 Raja S. Bobba and Mark A. Crowther 11 Perioperative Management of the Patient with Pulmonary Hypertension ..................................................... 137 Adriano R. Tonelli, Omar A. Minai, and Raed A. Dweik 12 Perioperative Management of the Neutropenic Rheumatologic Patient .................................................................. 155 Leonard J. Horwitz 13 Perioperative Management of the Patient with Chronic Kidney Disease, Hypertension, or End-Stage Renal Disease ......................................................... 165 James F. Simon and Joseph V. Nally 14 Systemic Lupus Erythematosus ................................................... 183 Elena Katzap and Richard A. Furie 15 Scleroderma and Raynaud Phenomenon .................................... 193 Corey M. Hat fi eld and Richard M. Silver 16 Perioperative Management of the Patient with Idiopathic In fl ammatory Myopathy ................................... 201 Rohit Aggarwal and Chester V. Oddis 17 Perioperative Management of Patients with Rheumatoid Arthritis ........................................................... 209 Lisa L. Schroeder and Mary Chester M. Wasko 18 Perioperative Management of the Patient with Takayasu’s Arteritis ............................................................. 221 Patrick Liang 19 Medical Issues in Osteoporotic Hip Fractures ........................... 233 Christopher M. Whinney 20 Total Joint Arthroplasty in the Patient with Connective Tissue Disease ................................................... 243 C. Ronald MacKenzie and Edwin P. Su 21 Postoperative Fever and Infection in Immunosuppressed Patients ........................................................ 253 David van Duin 22 Diagnosis and Management of Prosthetic Joint Infection ................................................................................ 261 Steven K. Schmitt Contents ix 23 Perioperative Gout and Pseudogout ............................................ 271 Brian F. Mandell 24 Perioperative Myocardial Infarction ........................................... 277 Benico Barzilai 25 Cervical Spine Stabilization ......................................................... 285 Christopher A. Iannotti and Gordon R. Bell 26 Laminectomy ................................................................................. 297 Fernando Techy and Gordon R. Bell 27 Vertebral Augmentation ............................................................... 303 Fernando Techy and R. Douglas Orr 28 Shoulder Arthroplasty .................................................................. 313 Jason D. Doppelt and Joseph P. Iannotti 29 Carpal Tunnel Surgery ................................................................