Anesthetic and Analgesic Management for Outpatient Knee Arthroplasty

Total knee arthroplasty traditionally has been associated with significant postoperative pain that can limit recovery and prolong hospital length of stay. Recently, however, due to financial pressures and an emphasis on improving patient satisfaction, many institutions are implementing outpatient and short-stay programs for patients undergoing this procedure. An effective perioperative anesthetic plan is an essential quality of a successful outpatient joint replacement program.

Improved technology and innovation has led to more effective and efficient strategies that contribute to a smoother and quicker postoperative course. The use of peripheral nerve blocks in conjunction with a variety of systemic analgesics has reduced post-operative pain compared to older modalities. Specifically, the adductor canal and IPACK blocks have become increasingly popular due to their analgesic efficacy and muscle sparing characteristics. Outpatient knee arthroplasty is becoming a reality with advancements in surgical pathways that incorporate these newer modalities with an emphasis on multidisciplinary coordination.