Rheumatoid Arthritis Disease – Quick overview
Airway
In rheumatoid arthritis, there is involvement of Temporomandibular Joint (TMJ)
C-spine fixed/subluxed and, therefore, can be unstable
Cricoarytenoid involvement should be suspected if a hoarse voice is present
Respiratory System
Costochondral involvement may cause a restrictive deficit and decreased tidal volume
Interstitial fibrosis with rheumatoid arthritis can cause a V/Q mismatch
Cardiovascular System
Coronary arteritis
Conduction abnormalities
Immobility may obscure underlying symptoms of CVS disease
Common diseases
Anemia
Chronic anemia often present
Treatment with NSAIDs can cause GI blood loss
Renal Failure
It may be caused by amyloidosis or chronic drug treatment
Treatment of Rheumatoid Arthritis
Steroid therapy
Steroid cover needed
Post-operative infection can occur
Tests
Complete blood count (CBC), Urea & Electrolytes (MBP/Chem7), CXR, C-spine, ECG, pulmonary function in some cases
Conduct of Anesthesia
Careful positioning
Have difficult intubation set available and ready
Awake fiberoptic if necessary
Regional blockade preferable