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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(02): e297-e306
DOI: 10.1055/s-0043-1771489
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Implantação do protocolo de recuperação rápida para artroplastia total do quadril em hospital público do estado de São Paulo – Brasil

Article in several languages: português | English
Leandro Gregorut Lima 
1   Arthron Serviços Médicos Especializados, São Paulo, SP, Brasil
2   Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
3   Hospital Regional de São José dos Campos, Instituto Sócrates Guanaes, São José dos Campos, SP, Brasil
,
Barbara Fialho Carvalho Sampaio 
3   Hospital Regional de São José dos Campos, Instituto Sócrates Guanaes, São José dos Campos, SP, Brasil
,
Marco Aurélio Silvério Neves 
1   Arthron Serviços Médicos Especializados, São Paulo, SP, Brasil
2   Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
3   Hospital Regional de São José dos Campos, Instituto Sócrates Guanaes, São José dos Campos, SP, Brasil
,
Alexandre Póvoa Barbosa 
2   Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Victor Edmond Seid 
4   Faculdade Albert Einstein, São Paulo, SP, Brasil
,
Fernanda Degobbi T. Q. S. Lopes 
2   Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Suporte Financeiro Os autores declaram que não receberam apoio financeiro de fontes públicas, comerciais, ou sem fins lucrativos para a realização deste estudo.
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Resumo

Objetivo Avaliar os resultados da implantação do Protocolo de Recuperação Rápida (PRR), prática médica baseada em evidências científicas, para cirurgia eletiva de artroplastia total do quadril principalmente comparando à Taxa Média de Internação Hospitalar nacional de 7.1 dias.

Métodos 98 pacientes submetidos a cirurgia eletiva de artroplastia total do quadril pela via direta anterior, via anterolateral e via posterior foram incluídos no PRR no período de dezembro de 2018 a março de 2020 sendo acompanhados no pré-operatório, intraoperatório e pós-operatório imediato.

Resultados a Taxa Média de Permanência Hospitalar foi de 2,8 dias, sendo 2,1 dias para a Via de Acesso Anterior, 3,0 dias para via de acesso anterolateral e 4,1 dias para via de acesso posterior. O tempo médio de cirurgia foi de 90 minutos, 19 (19,39%) dos pacientes foram encaminhados à UTI no pós-operatório, no entanto nenhum deles operado pela via direta anterior. Não tivemos casos de trombose venosa profunda (TVP), embolia pulmonar (TEP) ou lesão neurológica, 19 (19,39%) pacientes tiveram sangramento pós-operatório com necessidade de troca de curativo, 4 (4,08%) necessidade de transfusão sanguínea, 2 (2,04%) pacientes apresentaram instabilidade do implante, 1(1,02%) paciente teve fratura durante a cirurgia e 1(1,02%) paciente faleceu por complicações cardíacas.

Conclusão O PRR pode ser uma alternativa viável para diminuir o tempo de internação e as complicações pós-operatórias imediatas para a cirurgia eletiva de artroplastia total do quadril diminuindo 2 a 3 vezes o tempo de internação dos pacientes quando comparado com a média nacional de 7,1 dias.

Palavras-chave

artroplastia do quadril - artroplastia do joelho - protocolos clínicos

Trabalho desenvolvido no Hospital Regional de São José dos Campos – Instituto Sócrates Guanaes, São José dos Campos, SP, Brasil..




Publication History

Received: 21 September 2022

Accepted: 16 December 2022

Article published online:
10 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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