injection because it covers the posterior part of the knee, from where
the pain in total knee surgeries emanates. Adductor canal blocks, on
the other hand, only cover the anterior portion of the knee. While there
is certainly some promise here, more data is needed that prove the effi-
cacy of iPACK blocks.
Recipe for success
Outpatient joint replacement is a safe and effective procedure requiring a
total team effort from a group of multidisciplinary providers.
Anesthesiologists lead the way. Their abilities to identify candidates for
surgery, administer general anesthesia with a minimal number of short-act-
ing drugs at the lowest possible dose and manage pain with opioid-sparing
techniques have been key to moving more cases to ambulatory ORs.
OSM
2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 9
Dr. Joshi (girish.joshi@utsouthwestern.edu) is a professor of anesthesiology
and pain management at the University of Texas Southwestern Medical Center in
Dallas and past president of the Society for Ambulatory Anesthesia (SAMBA).
