Updates on Multimodal Analgesia and Regional Anesthesia for Total Knee Arthroplasty Patients

Publication date: Available online 6 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brandon S. Kandarian, Nabil M. Elkassabany, Mallika Tamboli, Edward R. MarianoAbstractThe subspecialty of regional anesthesiology and acute pain medicine (RAAPM) is in a position to lead changes that may impact the current opioid crisis. At the hospital level, RAAPM experts can implement evidence-based multimodal analgesic clinical pathways featuring regional anesthesia. Multimodal analgesia consists of using two or more analgesic modalities targeting pain pathways at various levels to improve pain control, while also aiming to reduce opioid utilization and related adverse effects. These types of pathways or protocols have been widely applied in the joint replacement population. This review will focus on the current state of the evidence regarding individual elements of a multimodal analgesic pathway for total knee arthroplasty patients including new regional anesthesia techniques like the IPACK (Infiltration between the Popliteal Artery and Capsule of the Knee) block and suggest future research directions to improve the clinical care of this surgical population in the years to come.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research