[Postoperative analgesia in joint replacement surgery]

Patients undergoing joint replacement surgery may experience intense and sustained postoperative pain due to inappropriate analgesia that delays recovery and hospital discharge. Traditionally, postoperative analgesia following arthroplasty is achieved with scheduled analgesia, either patient-controlled or with epidural spinal blocks. The former techniques have advantages and disadvantages. Recently, peripheral nerve block has emerged as an appropriate alternative for postoperative pain. Numerous trials report that the use of multimodal analgesia based on peripheral nerve blocks may control pain and offer functional results similar to those obtained with continuous epidural blocks or systemic opioids, but without their unwanted systemic effects. This review discusses the indications, benefits and adverse effects associated with standard and new analgesic techniques.