Current strategies in anesthesia and analgesia for total knee arthroplasty

Calin Stefan Moucha, Mitchell C. Weiser, Emily J. Levin

Research output: Contribution to journalReview article

65 Scopus citations

Abstract

Total knee arthroplasty is associated with substantial postoperative pain that may impair mobility, reduce the ability to participate in rehabilitation, lead to chronic pain, and reduce patient satisfaction. Traditional general anesthesia with postoperative epidural and patient-controlled opioid analgesia is associated with an undesirable adverse-effect profile, including postoperative nausea and vomiting, hypotension, urinary retention, respiratory depression, delirium, and an increased infection rate. Multimodal anesthesia - incorporating elements of preemptive analgesia, neuraxial perioperative anesthesia, peripheral nerve blockade, periarticular injections, and multimodal oral opioid and nonopioid medications during the perioperative and postoperative periods - can provide superior pain control while minimizing opioid-related adverse effects, improving patient satisfaction, and reducing the risk of postoperative complications.

Original languageEnglish (US)
Pages (from-to)60-73
Number of pages14
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Keywords

  • Nerve block
  • anesthesia
  • multimodal pain management
  • outcomes
  • periarticular injections
  • total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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