Perioperatives anästhesiologisches Vorgehen in der Knieendoprothetik

Perioperative anesthesiological management in total knee arthroplasty


Gesellschaftliche Trends und der begründete Wunsch der Menschen nach Eigenständigkeit führen weltweit zu einer Zunahme der Kniegelenksimplantationen. Studien belegen den Einfluss des perioperativen Managements auf den postoperativen Verlauf. Die Spinalanästhesie bietet Vorteile für das Outcome nach Knie-Totalendoprothese (TEP). Eine periphere Nervenblockade führt im postoperativen Verlauf zu einer deutlichen Verbesserung der Analgesiequalität. Die lokale Infiltrationsanalgesie durch den Operateur ist bei vergleichbaren Ergebnissen zunehmend populär. Risikoevaluierung, Aufklärung und ein auf die individuellen Bedürfnisse der Patienten abgestimmtes perioperatives Prozedere sind notwendige Schritte zum Therapierfolg.


In the next few years, the number of surgeries for elective total knee arthroplasty (TKA) will increase rapidly. For successful procedures it seems to be helpful to have standards for perioperative procedures. Neuroaxial anesthesia has benefits on postoperative outcome. Given comparable results, local infiltration analgesia by the surgeon is also becoming increasingly popular. Risk evaluation, medical examination and individualized procedures can help to prevent complications and improve patient outcome after elective TKA.

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Corresponding author

Correspondence to Martina Lange MD.

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M. Lange, G. Matziolis und E. Röhner geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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R. von Eisenhart-Rothe, München

R. Hube, München

W. Petersen, Berlin

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Lange, M., Matziolis, G. & Röhner, E. Perioperatives anästhesiologisches Vorgehen in der Knieendoprothetik. Knie J. 2, 9–14 (2020).

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  • Risikoevaluation
  • Spinalanästhesie
  • Periphere Nervenblockade
  • Lokale Infiltrationsanalgesie
  • Schmerztherapie


  • Risk evaluation
  • Spinal anesthesia
  • Peripheral nerve block
  • Local infiltration anesthesia
  • Pain management