The Journal of Bone and Joint Surgery (American). 2005;87:63-70.
doi:10.2106/JBJS.E.00491
© 2005 The Journal of Bone and Joint Surgery, Inc.
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A Comprehensive Anesthesia Protocol That Emphasizes Peripheral Nerve Blockade for Total Knee and Total Hip Arthroplasty

James R. Hebl, MD, Sandra L. Kopp, MD, Mir H. Ali, MD, PHD, Terese T. Horlocker, MD, John A. Dilger, MD, Robert L. Lennon, DO, Brent A. Williams, MS, Arlen D. Hanssen, MD and Mark W. Pagnano, MD

Corresponding author:
Mir H. Ali, MD, PhD
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address: ali.mir@mayo.edu

The first 150 words of the full text of this article appear below.


   Introduction
 
Recently, advances in radiographic imaging and surgical instrumentation have allowed experienced orthopaedic surgeons to perform total hip and total knee replacement surgery with surgical exposures that are less extensive than those associated with traditional techniques1,2. Commonly referred to as "minimally invasive total hip and total knee arthroplasty," these techniques are now being touted as important surgical advancements. The introduction of minimally invasive total hip and total knee techniques has been accompanied by substantial concomitant changes in perioperative anesthetic techniques, rapid rehabilitation protocols, and changes in patient education and expectations. However, the specific contribution of each of these changes to observed improvements after contemporary total hip and total knee arthroplasty remains unclear.

Tremendous strides in anesthesiology and perioperative pain management have been made with regard to the understanding of pain mechanisms and the importance of perioperative analgesia. The consequences of uncontrolled pain and medication-related side effects include the inability . . . [Full Text of this Article]


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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.
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 J Am Acad Orthop SurgHome page
T. T. Horlocker, S. L. Kopp, M. W. Pagnano, and J. R. Hebl
Analgesia for total hip and knee arthroplasty: a multimodal pathway featuring peripheral nerve block.
J. Am. Acad. Ortho. Surg., March 1, 2006; 14(3): 126 - 135.
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