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Background <p>Arthroscopic and joint surgery increasingly take place within fast track, short-stay and ambulatory pathways. This requires individualized anesthetic strategies, procedure-specific regional anesthesia and evidence-based fasting policies [<CitationRef CitationID="CR8">8</CitationRef>, <CitationRef CitationID="CR14">14</CitationRef>].</p> Objective <p>To summarize current anesthetic management and preoperative fasting strategies for adult and pediatric arthroscopic and joint surgery.</p> Material and methods <p>Narrative review of international guidelines, DACH recommendations, systematic reviews and procedure-specific recommendations.</p> Results <p>Ultrasound-guided regional anesthesia, modern preoperative fasting concepts and individualized aspiration-risk assessment support early recovery. Pediatric fasting policies in Austria and Germany support clear fluids until 1 h before anesthesia in healthy children. Glucagon-like peptide‑1 (GLP-1) receptor agonists require symptom-based and risk-adapted management and perioperative discontinuation of sodium glucose transporter&#xa0;2 (SGLT2) inhibitors is recommended [<CitationRef CitationID="CR1">1</CitationRef>, <CitationRef CitationID="CR2">2</CitationRef>, <CitationRef CitationID="CR4">4</CitationRef>, <CitationRef CitationID="CR5">5</CitationRef>, <CitationRef CitationID="CR7">7</CitationRef>, <CitationRef CitationID="CR15">15</CitationRef>, <CitationRef CitationID="CR16">16</CitationRef>].</p> Conclusion <p>Anesthesia is a&#xa0;central component of perioperative pathways in joint surgery and should be integrated into interdisciplinary early recovery after surgery (ERAS) concepts [<CitationRef CitationID="CR8">8</CitationRef>, <CitationRef CitationID="CR14">14</CitationRef>].</p>

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Anästhesieführung und präoperative Nüchternheit in der Gelenkchirurgie

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Markus F. Luger

摘要

Background

Arthroscopic and joint surgery increasingly take place within fast track, short-stay and ambulatory pathways. This requires individualized anesthetic strategies, procedure-specific regional anesthesia and evidence-based fasting policies [8, 14].

Objective

To summarize current anesthetic management and preoperative fasting strategies for adult and pediatric arthroscopic and joint surgery.

Material and methods

Narrative review of international guidelines, DACH recommendations, systematic reviews and procedure-specific recommendations.

Results

Ultrasound-guided regional anesthesia, modern preoperative fasting concepts and individualized aspiration-risk assessment support early recovery. Pediatric fasting policies in Austria and Germany support clear fluids until 1 h before anesthesia in healthy children. Glucagon-like peptide‑1 (GLP-1) receptor agonists require symptom-based and risk-adapted management and perioperative discontinuation of sodium glucose transporter 2 (SGLT2) inhibitors is recommended [1, 2, 4, 5, 7, 15, 16].

Conclusion

Anesthesia is a central component of perioperative pathways in joint surgery and should be integrated into interdisciplinary early recovery after surgery (ERAS) concepts [8, 14].