ANESTHESIA ON THE RHEUMATOID PATIENT

In the orthopedic setting, the anesthesiologist often encounters the r heumatoid patient after the disease has run a resistant course. Despit e optimal medical therapy, the patient at this point has intolerable l evels of pain or limitation of function because of structural joint da mage. Given the duration of the disease and severity of symptoms, a nu mber of pharmacologic modalities already have been tried for which the patient has suffered some side effects. Now that the disease has span ned a significant period, the patient has become older with one or mor e coexisting indications, and clinical results. Improvements in prosth etic design and surgical technique have resulted in more predictable r esults for total elbow replacement.