J Knee Surg 2018; 31(07): 600-604
DOI: 10.1055/s-0038-1636835
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contemporary Perioperative Analgesia in Total Knee Arthroplasty: Multimodal Protocols, Regional Anesthesia, and Peripheral Nerve Blockade

Jacob M. Drew
1  Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
,
Jonathan Neilio
2  University of New Hampshire, Durham, New Hampshire
,
Lisa Kunze
3  Department of Anesthesia, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

05 January 2018

28 January 2018

Publication Date:
07 March 2018 (eFirst)

Abstract

Perioperative care of the total knee arthroplasty (TKA) patient has evolved considerably over the past decade. Among the changes driving this evolution toward shorter hospitalization and accelerated rehabilitation have been regional anesthesia, peripheral nerve blockade, and multimodal analgesia protocols. These complementary techniques are increasingly supported by scientific evidence, though considerable uncertainty persists regarding the optimal combination of strategies. Continued refinement of technique and critical evaluation is trending toward greater characterization of the comparative effectiveness of myriad options. Contemporary interdisciplinary arthroplasty care teams have the opportunity to individualize the TKA patient's perioperative pain control to optimize not only the clinical outcome but also patient satisfaction.