SOLIS protocol, a specific anesthesia technique for hip and knee arthroplasty: Clinical results of 906 cases
Bibliographic record
Abstract
BACKGROUND: An optimized anesthetic protocol for joint arthroplasty should provide effective surgical anesthesia, promote early motor function recovery, and minimize postoperative pain and adverse effects. To meet these goals, we developed the SOLIS anesthesia protocol, which combines chloroprocaine short-acting Spinal anesthesia, an Opioid- and benzodiazepine-free anesthesia, large doses of Local anesthetics for Infiltration, and propofol Sedation. The objectives of this descriptive quality-improvement report were to determine whether the SOLIS protocol would provide effective anesthesia, enhance recovery, offer adequate postoperative pain control and be satisfactory for patients undergoing hip or knee replacement. HYPOTHESIS: It was hypothesized that the SOLIS protocol would meet these four objectives. PATIENTS AND METHODS: We reviewed 906 unilateral joint replacements: 265 total knee arthroplasties (TKAs), 32 unicompartimental knee arthroplasties (UKAs), and 609 total hip arthroplasties (THAs). The protocol efficacy was assessed by the rate of conversion to general anesthesia and the mean motor block duration, time to ambulation, the failure to ambulate on the day of surgery, and patient reported postoperative pain. Adverse events and complications were collected, and a subjective questionnaire was used to assess patients' satisfaction. RESULTS: There were no conversions to general anesthesia. The mean motor block duration was 89.7 ± 20.9 (88.0, 47.0-198.0) min, exceeding the mean time from injection to the end of surgery of 74.5 ± 16.5 (71.0, 39.0-140.0) min. On the day of surgery, only 1.3% of patients failed to ambulate. In the post-anesthesia care unit (PACU), the mean pain score was 1.7/10 ± 2.2 (1.0, 0.0-10.0), with 162 (17.9%) patients requiring opioids, which were oral for 85 (53%). Main complications were urinary retention requiring catheterization in eight (0.9%), orthostatic hypotension during the first ambulation was observed in 42 (4.6%). Deep vein thrombosis occurred in two (0.2%), and pulmonary embolism in one (0.1%). Patients rated at 98% their satisfaction with the anesthesia protocol and 96% for the postoperative pain management. CONCLUSION: SOLIS is a very effective anesthesia protocol for hip and knee replacement, promoting enhanced recovery with low postoperative pain, and achieving a very high patient satisfaction rate. However, implementing this protocol may require a dedicated arthroplasty team and environment. LEVEL OF EVIDENCE: IV; continuous case series with no comparison group.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.003 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".