Which complication is most common in the pulmonary category during orthopedic surgery?

Aspiration is considered the most common pulmonary complication during orthopedic surgery primarily due to the nature of patient positioning, sedation, and the handling of the airway during procedures. In many orthopedic surgeries, particularly those involving the lower extremities, patients are often sedated or placed under general anesthesia, which can impair their protective airway reflexes. This lack of protective reflexes increases the risk of stomach contents entering the airway, especially if patients have not adhered to fasting guidelines before surgery.

The risk is further heightened during certain orthopedic procedures where patients are in a supine or lateral position, which can make it easier for aspirated materials to enter the lungs. Aspiration can lead to pulmonary complications such as aspiration pneumonia, which can significantly impact patient recovery and overall outcomes following surgery.

Other options, while they can occur, are less frequent in the context of orthopedic surgeries. For example, pneumothorax and hemothorax are generally more associated with thoracic procedures or trauma rather than orthopedic surgery. Bronchospasm can happen during anesthesia but is not as directly linked to orthopedic procedures as aspiration is. Understanding these dynamics is crucial for preoperative risk assessment and patient safety management in orthopedic settings.