Acadia Room
New Orleans Marriott
555 Canal Street
New Orleans, LA 70130
Wednesday, March 10, 2010
This activity is provided free of charge to participants.
Registration and Dinner: 6:00 pm - 6:30 pm
Educational Session: 6:30 pm - 9:00 pm
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Pre register and attend to receive a COMPLIMENTARY USB wallet card
loaded with the content from the symposium (subject to availability).
CONTROL THE BLEEDING...
Venous thromboembolism (VTE) is an important patient safety issue. Almost all hospitalized patients have risk factors for VTE — in fact, 40% have >3 risk factors. Without thromboprophylaxis, the incidence of hospital-acquired deep vein thrombosis (DVT) is approximately 10% to 40% among all medical or general surgical patients. In patients undergoing major orthopedic surgery, the incidence of DVT can be as high as 60%. Among all hospitalized patients, VTE is the second most common medical complication, the second most common cause of excess length of stay, and the third most common cause of excess mortality and charges.
The rationale for the use of thromboprophylaxis is based on solid principles and scientific evidence. There is considerable evidence for routine thromboprophylaxis of most hospitalized patient groups. Among patients undergoing major orthopedic surgery, routine thromboprophylaxis has been the standard of care for >20 years. While routine thromboprophylaxis has made fatal PE an uncommon event, symptomatic VTE continues to be reported in up to 10% of patients after surgery. Moreover, the risk continues to be higher than expected for >2 months after surgery. VTE remains the most common reason for readmission to the hospital following major orthopedic surgery.
These data suggest that gaps remain in the provision of adequate thromboprophylactic modalities to patients following major orthopedic surgery. Furthermore, established treatments for thromboprophylaxis (eg, adjusted-dose oral vitamin K antagonists and low-molecular-weight heparins) are subject to a number of efficacy, safety, and compliance limitations that have reduced their impact on VTE in real-world clinical practice. Recently reported trials and new agents continue to redefine optimal thromboprophylactic strategies for patients undergoing orthopedic surgery. Additionally, newer guidelines and patient safety requirements help to address these challenges.
CONTROL THE PAIN...
Concomitantly with recent advances in thromboprophylaxis following orthopedic surgery, there has been an evolution in paradigms for acute and chronic pain management in patients undergoing orthopedic surgery. Adequate pain control not only benefits the patient directly but can speed mobilization, hasten rehabilitation, improve patient satisfaction, possibly permit earlier discharge, and reduce the likelihood of life-threatening events associated with extended hospitalization, such as DVT.
Currently, a number of choices are available to orthopedic surgeons for pain management. These include narcotics (both oral and intravenous), nerve blocks, pain pumps, epidural injections, aspirin, nonsteroidal anti-inflammatory drugs (oral and intravenous), transdermal patches, and muscle relaxants. Despite the availability of these options, periprocedural pain in patients undergoing orthopedic surgery continues to be undertreated; in fact, up to 76% of surgical patients experience moderate to severe pain following surgery. These data clearly suggest that adequate pain control among patients undergoing orthopedic surgery remains suboptimal.
To address the gaps in thromboprophylaxis and pain management outlined above, this program will examine the key elements of VTE prevention and pain management, as delineated by public health and professional medical societies. It will also critically review available data for existing therapies and novel agents for the prevention of VTE and for pain management. It is hoped that the content presented in this program will prove valuable in improving care of patients awaiting, undergoing, or recovering from orthopedic surgery.
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