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Recovery after orthopedic surgery: techniques to increase duration of pain control

Boezaart, André P.; Davis, Gordon; Le-Wendling, Linda

Current Opinion in Anaesthesiology: December 2012 - Volume 25 - Issue 6 - p 665–672
doi: 10.1097/ACO.0b013e328359ab5a
AMBULATORY ANESTHESIA: Edited by J. Lance Lichtor

Purpose of review: Ambulatory surgery continues to expand in scope and volume. Part of this development is supported by improvements in anesthesia care, especially in the realm of postoperative analgesia, which is often outlasted by the pain. The purpose of this review is to outline methods of increasing the duration of postoperative pain control.

Recent findings: There have been recent advances in the use of perineural catheters for the performance of continuous nerve blocks, the use of adjuvants to extend the duration of single dose blocks, methods to improve the technical performance of blocks, systemic multimodal analgesia, and novel or experimental agents.

Summary: The ideas and findings described in this review are taken from the most recent literature and show promise of aiding in the continued improvement of patient care through their dissemination and refinement by further research. Of the modalities reviewed in current use, the continuous perineural catheter combined with systemic multimodal analgesics represents the best combination of safety and efficacy to provide prolonged postoperative analgesia.

Division of Acute and Peri-operative Pain Medicine, Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA

Correspondence to André P. Boezaart, MD, PhD, Department of Anesthesiology, 1600 SW Archer Rd, Gainesville, FL 32610, USA. Tel: +1 352 213 3272; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.