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Anesthesia for the patient undergoing total knee replacement: current status and future prospects

Authors Turnbull ZA, Sastow D, Giambrone GP, Tedore T

Received 9 November 2016

Accepted for publication 16 January 2017

Published 8 March 2017 Volume 2017:10 Pages 1—7

DOI https://doi.org/10.2147/LRA.S101373

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Dr Stefan Wirz


Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore

Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA

Abstract: Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality. Anesthesiologists are also moving toward multimodal analgesia, which includes peripheral nerve blockade, periarticular injection, and preemptive analgesia. The goal of multimodal analgesia is to improve perioperative pain control while minimizing systemic narcotic consumption. With improved postoperative pain management and rapid patient rehabilitation, new clinical pathways have been engineered to fast track patient recovery after orthopedic procedures. The aim of these clinical pathways was to improve quality of care, minimize unnecessary variations in care, and reduce cost by using streamlined procedures and protocols. The future of TKA care will be formalized clinical pathways and tracks to better optimize perioperative algorithms with regard to pain control and perioperative rehabilitation.

Keywords: TKA, regional anesthesia, analgesia

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