Creation of a “prosthesis school” within a fast-track clinical pathway for total knee arthroplasty.

Authors

  • Rocío Castellanos González Specialist in the Anesthesiology and Resuscitation Service of the Getafe University Hospital, Madrid.
  • María Jesús Jiménez García Specialist in the Anesthesiology and Resuscitation Service of the Getafe University Hospital, Madrid.
  • Irene Alonso Ramos Specialist in the Anesthesiology and Resuscitation Service of the Getafe University Hospital, Madrid.
  • Mario Abel Morales Cayuela Resident of the Anesthesiology and Resuscitation Service of the Getafe University Hospital, Madrid.

DOI:

https://doi.org/10.30445/rear.v13i1.880

Keywords:

Multimodal analgesia, adductor canal block, periarticular infiltration

Abstract

In the last decades, rapid recovery or fast-track surgeries become more important to mitigate surgical stress and organic dysfunction caused by surgical aggression, and so, decreasing postoperative complications. It improves a better pain control and an acelerated recovery, and as consecuence, an early hospital discharge and a positive experience for the patient. The target is decrease stress response and minimize pain and discomfort.

We have established a fast-track clinical pathway in our hospital to acelerate and improve postoperative recovery in patients undergoing total knee arthroplasty. The succesful of this program is based on a multimodal and multidisciplinary approach between the different professionals (surgeons, anesthesiologist, nursery, rehabilitation and physiotherapy).

References

- Molko S, Combalia A. La cirugía de recuperación rápida en las artroplastias de rodilla y cadera. Una acutalización. Rev Esp Cir Ortop Traumatol. 2017 Mar - Apr;61(2):130-138. doi:10.1016/j.recot.2017.01.002. Epub 2017 Feb 21. Review. English, Spanish. PubMed. PMID: 28233658

- Kopp SL, Børglum J, Buvanendran A, Horlocker TT, Ilfeld BM, Memtsoudis SG, Neal JM, Rawal N, Wegener JT. Anesthesia and Analgesia Practice Pathway Options for Total Knee Arthroplasty: An Evidence-Based Review by the American and European Societies of Regional Anesthesia and Pain Medicine. Reg Anesth Pain Med. 2017 Nov/Dec;42(6):683-697. doi: 10.1097/AAP.0000000000000673. Review. PubMed PMID: 29053504.

- Larsen K, Hansen TB, Thomsen PB, Christiansen T, Soballe K. Cost-effectiveness of accelerated perioperative care and rehabilitation after total hip and knee arthroplasty. J Bone Joint Surg Am. 2009;91:761-72

- Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H. Economic consequences of accelerated care pathways in total knee arthroplasty. Ugeskr Laeger. 2009;171:3276-80

- Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H. Why still in hospital after fast-track hip and knee arthroplasty? Acta Orthop 2011;82:679-84

- Joshi GP, Schug SA, Kehlet H. Procedure-specific pain management and outcome
strategies. Best Pract Res Clin Anaesthesiol. 2014 Jun;28(2):191-201. doi:
10.1016/j.bpa.2014.03.005. Epub 2014 May 9. Review. PubMed PMID: 24993439.

- Russo MW, Parks NL, Hamilton WG. Perioperative Pain Management and Anesthesia: A Critical Component to Rapid Recovery Total Joint Arthroplasty. Orthop Clin North Am. 2017 Oct;48(4):401-405. doi: 10.1016/j.ocl.2017.06.006. Review. PubMed PMID: 28870301

- Capdevila X, Barthelet Y, Biboulet P, Ryckwaert Y, Rubenovitch J, d'Athis F.
Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology. 1999 Jul;91(1):8-15. PubMed PMID: 10422923

- Ben-Ari A, Chansky H, Rozet I. Preoperative opioid use is associated with early revision after total knee arthroplasty: a study of male patients treated in the Veterans affairs system. J Bone Joint Surg Am 2017;99:1e9.

- Guild GN 3rd, Galindo RP, Marino J, Cushner FD, Scuderi GR. Periarticular regional analgesia in total knee arthroplasty: a review of the neuroanatomy and injection technique. Orthop Clin North Am. 2015 Jan;46(1):1-8. doi:10.1016/j.ocl.2014.09.016. Review. PubMed PMID: 25435030

- Tanikawa H, Harato K, Ogawa R, et al. Local infiltration of analgesia and sciatic nerve block provide similar pain relief after total knee arthroplasty. J Orthop Surg Res 2017;12:109

- Marina Fernandez R, Ginés Mateos G, Arco Pérez MC, Nuevo Gayoso M, Faura Vendrell T. Gestión del dolor en pacientes del programa Rapid Recovery (RR) en artroplastia total de rodilla (ATR). Rev Rol Enf. 2015;38:420-5.

- Jorgensen CC, Kehlet H. Role of patient characteristics for fast.track hip and knee arthrooplasty. Br J Anaesth 2013;110:972-980

Published

2021-02-08

How to Cite

Castellanos González, R., Jiménez García, M. J., Alonso Ramos, I., & Morales Cayuela, M. A. (2021). Creation of a “prosthesis school” within a fast-track clinical pathway for total knee arthroplasty. Revista Electrónica AnestesiaR, 13(1). https://doi.org/10.30445/rear.v13i1.880