A comprehensive anesthesia protocol that emphasizes peripheral nerve blockade for total knee and total hip arthroplasty.

摘要: R ecently, advances in radiographic imaging and surgical instrumentation have allowed experienced orthopaedic surgeons to perform total hip knee replacement surgery with exposures that are less extensive than those associated traditional techniques1,2. Commonly referred as “minimally invasive arthroplasty,” these techniques now being touted important advancements. The introduction of minimally has been accompanied by substantial concomitant changes perioperative anesthetic techniques, rapid rehabilitation protocols, patient education expectations. However, the specific contribution each observed improvements after contemporary arthroplasty remains unclear. Tremendous strides anesthesiology pain management made regard understanding mechanisms importance analgesia. consequences uncontrolled medication-related side effects include inability actively participate rehabilitation, delayed recovery, poor or suboptimal outcome, prolonged hospitalization, greater use health-care resources3. Traditionally, administration intravenous opioids mainstay for postoperative analgesia following arthroplasty. parenteral commonly inadequate relief, generalized sedation, adverse such nausea, vomiting, gastrointestinal ileus, pruritus. In response, some anesthesiologists embraced concept “preemptive multimodal analgesia.” Preemptive involves analgesics prior painful stimuli order prevent central sensitization thus amplification pain4. Multimodal refers combined analgesic regimens treatment pain. For example, low-dose opioids, local infiltration, peripheral nerve blockade, nonsteroidal anti-inflammatory drugs, corticosteroids, clonidine, cryotherapy all used various combinations manage …