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World J Orthop. Jul 18, 2014; 5(3): 283-291
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.283
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.283
Perioperative management of the patient with rheumatoid arthritis
Megan L Krause, Eric L Matteson, Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: Krause ML and Matteson EL solely contributed to this paper.
Correspondence to: Eric L Matteson, MD, MPH, Professor, Division of Rheumatology, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States. matteson.eric@mayo.edu
Telephone: +1-507-2848450 Fax: +1-507-2840564
Received: December 2, 2013
Revised: March 20, 2014
Accepted: May 8, 2014
Published online: July 18, 2014
Revised: March 20, 2014
Accepted: May 8, 2014
Published online: July 18, 2014
Core Tip
Core tip: Patients with rheumatoid arthritis (RA) require specialized care in the perioperative setting. Special attention must be given to management of immunomodulatory therapies, temporarily suspending their administration in the perioperative period. Patients on corticosteroids may require stress doses. Anesthesiologists should be aware of the possibility of cervical spine disease and appropriate measures, including obtaining cervical spine radiographs preoperatively. Patient with RA are at heightened infection risk because of their disease and its treatment, requiring particular vigilance in the postoperative period.