Current Strategies in Anesthesia and Analgesia for Total Knee Arthroplasty

The Journal of the American Academy of Orthopaedic Surgeons
Calin Stefan MouchaEmily J Levin

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.

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Citations

Mar 13, 2018·Clinical Orthopaedics and Related Research·Joseph J KavolusPaul F Lachiewicz
Apr 25, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Derek M KlavasStephen J Incavo
Jul 6, 2018·The Journal of Bone and Joint Surgery. American Volume·Matthew J GrossoJeffrey A Geller
Oct 6, 2017·The Open Orthopaedics Journal·Joao Paulo Fernandes GuerreiroDaniele Cristina Cataneo
Nov 10, 2017·Current Opinion in Anaesthesiology·Huiqun FuTianlong Wang
Sep 4, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Jared WarrenNicolas S Piuzzi
Feb 1, 2019·Regional Anesthesia and Pain Medicine·John TranAnne M R Agur
Feb 14, 2018·Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association·Melissa A Schneider
Jul 17, 2019·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Seshadri C MudumbaiEdward R Mariano
Oct 31, 2019·Orthopaedic Surgery·Jing-Wen LiLiang-Kun Xiao
Jan 9, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Mutlu AkdoğanMehmet Faruk Çatma
Mar 1, 2020·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Jörg LütznerFranziska Beyer
Jan 27, 2019·Journal of Orthopaedic Trauma·Joseph R HsuUNKNOWN Orthopaedic Trauma Association Musculoskeletal Pain Task Force
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Feb 9, 2021·Arthroplasty Today·Keenan AtwoodAdam E Klein
Nov 2, 2020·Pain Management Nursing : Official Journal of the American Society of Pain Management Nurses·Joanne M Laframboise-OttoAnn L Horgas
Apr 4, 2021·Healthcare·Sara J HylandRobert K Cleary
Sep 6, 2017·The Orthopedic Clinics of North America·Matthew W RussoWilliam G Hamilton
Jul 8, 2021·The Journal of Bone and Joint Surgery. American Volume·Joseph A KaramJavad Parvizi
Oct 8, 2021·Orthopedics·Aakash A Shah, Abha A Shah
Apr 18, 2019·Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre·Xiao-Ying ZhaoJian-Xin Yang

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