title: Recovery after orthopedic surgery:  techniques to increase duration of pain control.
abstract: OBJECTIVE
  Ambulatory surgery continues to expand in scope and volume. Part of this development is supported by improvements in anesthesia care, especially in the realm of postoperative analgesia, which is often outlasted by the pain. The purpose of this review is to outline methods of increasing the duration of postoperative pain control.
  
  
  RESULTS
  There have been recent advances in the use of perineural catheters for the performance of continuous nerve blocks, the use of adjuvants to extend the duration of single dose blocks, methods to improve the technical performance of blocks, systemic multimodal analgesia, and novel or experimental agents.
  
  
  CONCLUSIONS
  The ideas and findings described in this review are taken from the most recent literature and show promise of aiding in the continued improvement of patient care through their dissemination and refinement by further research. Of the modalities reviewed in current use, the continuous perineural catheter combined with systemic multimodal analgesics represents the best combination of safety and efficacy to provide prolonged postoperative analgesia.
authors.affiliation: Division of Acute and Peri-operative Pain Medicine, Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA. aboezaart@anest.ufl.edu
authors.forename: André P
authors.initials: AP
authors.lastname: Boezaart
authors.forename: Gordon
authors.initials: G
authors.lastname: Davis
authors.forename: Linda
authors.initials: L
authors.lastname: Le-Wendling
mesh_terms: D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D017024:Chemotherapy, Adjuvant; D004359:Drug Therapy, Combination; D006801:Humans; D009407:Nerve Block; D019637:Orthopedic Procedures / Q000009:adverse effects*; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents