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 Mark W. Pagnano, MDHip Knee
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.
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