title: Total knee arthroplasty as an overnight-stay procedure using continuous femoral nerve blocks at home: a prospective feasibility study.
abstract: The average duration of hospitalization after total knee arthroplasty (TKA) in the United States is 4-5 days. In this two-phase study we investigated the feasibility of converting TKA into an overnight-stay procedure using a continuous femoral nerve block provided at home through postoperative day 4. Nine of 10 patients met discharge criteria and were discharged home the day after surgery. Pain was well controlled, opioid requirements and sleep disturbances were minimal, and patient satisfaction was high. Additional research is required to replicate these results in a controlled trial, define the appropriate subset of patients, and assess the incidence of complications associated with this practice before its mainstream use.
authors.affiliation: Department of Anesthesiology, PUniversity of Florida, Gainesville, Florida, USA. bilfeld@ulf.edu
authors.forename: Brian M
authors.initials: BM
authors.lastname: Ilfeld
authors.forename: Peter F
authors.initials: PF
authors.lastname: Gearen
authors.forename: F Kayser
authors.initials: FK
authors.lastname: Enneking
authors.forename: Linda F
authors.initials: LF
authors.lastname: Berry
authors.forename: Eugene H
authors.initials: EH
authors.lastname: Spadoni
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
authors.forename: Krista
authors.initials: K
authors.lastname: Vandenborne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D000577:Amides / Q000008:administration & dosage; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D011446:Prospective Studies; D000077212:Ropivacaine; D013997:Time Factors
chemical_list: D000577:Amides; D000077212:Ropivacaine