MBChB, PhD, FRCA,
FFARCSI, FRCPC,
medical director of
anesthesiology at The
Ottawa Hospital in
Ottawa, Canada.
"There's some evi-
dence that patients
with more significant
acute pain after sur-
gery go on to have
higher rates of chron-
ic pain."
Dr. McCartney says
recently published
evidence suggests
knee replacement
under spinal anesthe-
sia results in lower
incidences of mortality, infection, admission to ICU and respiratory
complications.
"There's no question regional anesthesia provides better pain con-
trol after knee replacement, but unfortunately there hasn't been suffi-
cient argument for facilities to change their practice," he says. "You
see that in the rates of general versus regional — approximately 75%
of patients still get a general anesthetic for a knee replacement."
There are a multitude of reasons for regional's lack of widespread
use during knee replacements, including institutional barriers: The
blocks take longer than general anesthesia to take effect, patients
expect to receive inhalational and are uncomfortable with being
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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2 0 1 5
z BACKBONE OF SUCCESS
Spinal anesthesia is one of the
keys to lowering rates of post-
op mortality and morbidity.
