Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postopera...Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postoperative pain,and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery.The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal.Many different approaches and techniques for peripheral nerve blockades,either landmark or,more recently,ultrasound guided have been described over the last decades.This includes but is not restricted to techniques discussed in this review.The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block.Moreover,ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block.In contrast to patient controlled analgesia using opioids,patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction;this is important as hospital rank-ings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure.This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications,considerations and outcomes.展开更多
Over the last decades the demand for hip surgery,be it elective or in a traumatic setting,has greatly increased and is projected to expand even further.Concurrent with demographic changes the affected population is bu...Over the last decades the demand for hip surgery,be it elective or in a traumatic setting,has greatly increased and is projected to expand even further.Concurrent with demographic changes the affected population is burdened by an increase in average comorbidity and serious complications.It has been suggested that the choice of anesthesia not only affects the surgery setting but also the perioperative outcome as a whole.Therefore different approaches and anesthetic techniques have been developed to offer individual anesthetic and analgesic care to hip surgery patients.Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome,showing favorable results in the usage of regional vs general anesthesia.In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome.While there still remains a scarcity of data investigating perioperative outcomes and anesthesia,most studies concur on a positive outcome in overall mortality,thromboembolic events,blood loss and transfusion requirements when comparing regional to gener-al anesthesia.Much of the currently available evidence suggests that a comprehensive medical approach with emphasis on regional anesthesia can prove beneficial to patients and the health care system.展开更多
文摘Over the last decades,the number of total knee arthroplasty procedures performed in the United States has been increasing dramatically.This very successful intervention,however,is associated with significant postoperative pain,and adequate postoperative analgesia is mandatory in order to allow for successful rehabilitation and recovery.The use of regional anesthesia and peripheral nerve blocks has facilitated and improved this goal.Many different approaches and techniques for peripheral nerve blockades,either landmark or,more recently,ultrasound guided have been described over the last decades.This includes but is not restricted to techniques discussed in this review.The introduction of ultrasound has improved many approaches to peripheral nerves either in success rate and/or time to block.Moreover,ultrasound has enhanced the safety of peripheral nerve blocks due to immediate needle visualization and as consequence needle guidance during the block.In contrast to patient controlled analgesia using opioids,patients with a regional anesthetic technique suffer from fewer adverse events and show higher patient satisfaction;this is important as hospital rank-ings and advertisement have become more common worldwide and many patients use these factors in order to choose a certain institution for a specific procedure.This review provides a short overview of currently used regional anesthetic and analgesic techniques focusing on related implications,considerations and outcomes.
文摘Over the last decades the demand for hip surgery,be it elective or in a traumatic setting,has greatly increased and is projected to expand even further.Concurrent with demographic changes the affected population is burdened by an increase in average comorbidity and serious complications.It has been suggested that the choice of anesthesia not only affects the surgery setting but also the perioperative outcome as a whole.Therefore different approaches and anesthetic techniques have been developed to offer individual anesthetic and analgesic care to hip surgery patients.Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome,showing favorable results in the usage of regional vs general anesthesia.In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome.While there still remains a scarcity of data investigating perioperative outcomes and anesthesia,most studies concur on a positive outcome in overall mortality,thromboembolic events,blood loss and transfusion requirements when comparing regional to gener-al anesthesia.Much of the currently available evidence suggests that a comprehensive medical approach with emphasis on regional anesthesia can prove beneficial to patients and the health care system.
