Abstract
Two facts should be underlined before discussing this topic: (1) in recent years the anesthetist “went out” the operation theater to be more and more involved in post-operative care; (2) it doesn’t exist a “gold standard “ in anesthesia, but the possible options are many and varied. The term “anesthesia” usually includes general (intravenous, inhalatory, mixed) and loco-regional anesthesia, plus MAC (Monitored Anesthesia Care). In this paper, the three options are briefly analyzed in order to understand the implications and the pros vs cons of each, with the objective of offering some suggestions about the best choice in knee replacement surgery. The conclusions support regional anesthesia, fully integrated with MAC to minimize (or cancel) post-operative pain.
Similar content being viewed by others
Bibliografia
Capdevila X, Barthelet Y, Biboulet P et al. (1999) Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology 91:8–15
Allen HW, Liu SS, Ware PD et al. (1998) Peripheral nerve blocks improve analgesia after total knee replacement surgery. Anesth Analg 87:93–97
Ghisi D, Fanelli A, Tosi M et al. (2005) Monitored anesthesia care. Minerva Anestesiol 71:533–538
American Society of Anesthesiologists (1998) ASA updates its position on monitored anesthesia care. ASA Newsletter 62(12):1–6
American Society of Anesthesiologists (2003) Practice guidelines for management of the difficult airway: an updated report by the American society of anesthesiologists task force on management of the difficult airway. Anesthesiology 98:1269–1277
Barrington MJ, Olive D, Low K et al. (2005) Continuous femoral nerve blockade or epidural analgesia after total knee replacement: a prospective randomized controlled trial. Anesth Analg 101:1824–1829
Vendittoli PA, Makinen P, Drolet P et al. (2006) A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study. J Bone Jt Surg Am 88:282–289
Paul JE, Arya A, Hurlburt L et al. (2010) Femoral nerve block improves analgesia outcomes after total knee arthroplasty: a meta-analysis of randomized controlled trials. Anesthesiology 113:1144–1162
Morin AM, Kratz CD, Eberhart LH et al. (2005) Postoperative analgesia and functional recovery after total-knee replacement: comparison of a continuous posterior lumbar plexus (psoas compartment) block, a continuous femoral nerve block, and the combination of a continuous femoral and sciatic nerve block. Reg Anesth Pain Med 30:434–445
Conflitto di interesse
Nessuno.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Oriani, G., Oriani, A. Anestesia nella chirurgia protesica del ginocchio. LO SCALPELLO 27, 95–100 (2013). https://doi.org/10.1007/s11639-013-0044-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11639-013-0044-6