some discomfort 3 or
4 days later, but noth-
ing like what they
experienced before.
Their range of motion
is better, the number
of falls is down and I
haven't had any
patients going back to
the emergency room
for pain control."
Block time
There's no question
that regional blocks
have become a cor-
nerstone when it
comes to the dual
goal of managing pain
and preparing
patients for rapid dis-
charge. Nearly two-
thirds (62%) of
respondents say sin-
gle-injection blocks are among the multimodal options they rely on.
And those who haven't fully accepted their importance may be pay-
ing a price.
A Nebraska CRNA — one of the few who admits that her facility's
approach to pain isn't working — bemoans the fact that the "sur-
geon only allows general anesthesia and infiltrates with a local at
9 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J a n u a r y 2 0 1 7
Here are the agents our survey respondents use
to manage pain in TKa patients. nearly two-
thirds said they rely on blocks and nSaIDs as
part of their multimodal regimens.
Single-injection nerve blocks 62.15%
nSaIDS 60.45%
Short-acting opioids 52.54%
acetaminophen 46.33%
Gabapentinoids 35.03%
Local anesthesia (bupivacaine) 31.64%
Local anesthesia (Exparel) 30.51%
Long-acting opioids 24.29%
Continuous perineural catheters 22.03%
Steroids 20.34%
IV PCa opioids 18.64%
Ketamine 14.12%
Other 6.21%
SOURCE: Outpatient Surgery Magazine reader
Survey, December 2016, n=177
MANY WEAPONS
Managing TKA Pain
