Clinical Procedure
 
Aliases:
TKR
TKJR

Topic aliases are alternate phrasings for a particular topic.


Duration 2-4hrs

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


Lower limb dermatomes. By spinal root refl.in/q By peripheral nerve refl.in/1o

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


Deep vein thrombosis (DVT) risk high (give LMWH).
Chest 2008;133;71S-109 refl.in/u

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , Pieter Peach , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


General anaesthesia, multimodal analgesia, PCA

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , Pieter Peach , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


General anesthesia plus fascia iliaca block, single shot, to cover anterior knee pain for 6-12hrs. Regular oral analgesia plus postoperative PCA

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


General plus epidural anaesthesia, and postoperative epidural anesthesia. #ref

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


Aug 14, 2011
Surgeon may prefer early mobilisation which an epidural with local anesthetic would make difficult
Good review article on regional anaesthetic options for TKR.

The Optimal Analgesic Block for Total Knee Arthroplasty Reg Anesth Pain Med 2016;41: 711–719 www.ncbi.nlm.nih.gov/pubm...

dx.doi.org/10.1097/AAP.00...

"Femoral triangle block guided by internal anatomical structures visible with ultrasonography or midway between the ASIS and the base of patella provides effective analgesia after medial parapatellar arthrotomy through the integument and the extra-articular retinaculum of the medial part of the knee. However, it does not alleviate pain deriving from the popliteal nerve branches innervating the intra-articular excision component of TKA. Supplemental blockade of the popliteal plexus by an obturator nerve block or local anesthetic infiltration of the posterior genicular capsule or local infiltration of the interspace between the popliteal artery and the capsule of the posterior knee is required."

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


Perioperative oral pregabalin and neuropathic pain following total knee replacement at 3 and 6 months.

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


2
Sciatic nerve block can be used as rescue analgesia for posterior knee pain in recovery if femoral or fascia iliaca block is used. Supine position, lateral approach, with knee and hip flexion.

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


Jul 23, 2011
This will provide analgesia for 6-12 hours, but will be painful when it wears off. Alternative approach is to administer adequate intraoperative narcotic analgesia with postop PCA
Spinal anaesthesia plus regular oral analgesia plus postoperative PCA

Improve to correct grammar or spelling, but do not significantly alter the substance of the original author's text.


Cancel
attachment
Endorsed by , more...
Locksmallsmush Private
Locksmallsmush only
Locksmallsmush only


Aug 14, 2011
Large volume spinal (eg 3ml 0.5% bupivicaine) #ref