HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Horlocker, T. T. Articles by Hebl, J. R. Search for Related Content PubMed PubMed Citation Articles by Horlocker, T. T. Articles by Hebl, J. R.

Analgesia for Total Hip and Knee Arthroplasty: A Multimodal Pathway Featuring Peripheral Nerve Block

Dr. Horlocker is Professor of Orthopedics and Professor of Anesthesiology, Department of Anesthesiology, Mayo Graduate School of Medicine, Mayo Clinic, Rochester, MN. Dr. Kopp is Instructor of Anesthesiology, Department of Anesthesiology, Mayo Graduate School of Medicine, Mayo Clinic. Dr. Pagnano is Associate Professor of Orthopaedics, Department of Orthopedic Surgery, Mayo Graduate School of Medicine, Mayo Clinic. Dr. Hebl is Assistant Professor of Anesthesiology, Department of Anesthesiology, Mayo Graduate School of Medicine, Mayo Clinic.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Horlocker, Dr. Kopp, Dr. Pagnano, and Dr. Hebl.

Reprint requests: Dr. Horlocker, Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Patients undergoing total hip and knee arthroplasty experience substantial and sustained postoperative pain. Inadequate analgesia may impede physical therapy and rehabilitative efforts and delay hospital dismissal. Traditionally, postoperative analgesia after total joint replacement was provided by either intravenous patient-controlled analgesia or epidural analgesia. Each, however, had disadvantages as well as advantages. Peripheral nerve blockade of the lumbosacral plexus has emerged as an alternative analgesic approach. In several studies, unilateral peripheral block provided a quality of analgesia and functional outcomes similar to those of continuous epidural analgesia and superior to those of systemic analgesia, but with fewer side effects because of their opioid-sparing properties. Peripheral nerve block techniques may be the optimal analgesic method following total joint arthroplasty.

This article has been cited by other articles:

				J. E. Chelly Do We Really Need an Interval Between Administering Fondaparinux and Removing a Lumbar Plexus Catheter? Anesth. Analg., February 1, 2009; 108(2): 670 - 671. [Full Text] [PDF]

				J. Marino, J. Russo, M. Kenny, R. Herenstein, E. Livote, and J. E. Chelly Continuous Lumbar Plexus Block for Postoperative Pain Control After Total Hip Arthroplasty. A Randomized Controlled Trial J. Bone Joint Surg. Am., January 1, 2009; 91(1): 29 - 37. [Abstract] [Full Text] [PDF]

				S. T. Touray, M. A. de Leeuw, W. W. A. Zuurmond, and R. S. G. M. Perez Psoas compartment block for lower extremity surgery: a meta-analysis Br. J. Anaesth., December 1, 2008; 101(6): 750 - 760. [Abstract] [Full Text] [PDF]

				S. J. Fowler, J. Symons, S. Sabato, and P. S. Myles Epidural analgesia compared with peripheral nerve blockade after major knee surgery: a systematic review and meta-analysis of randomized trials Br. J. Anaesth., February 1, 2008; 100(2): 154 - 164. [Abstract] [Full Text] [PDF]

				W. P. Cooney III New directions. J. Am. Acad. Ortho. Surg., March 1, 2006; 14(3): 121 - 122. [Full Text] [PDF]