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Anesthesia for Ambulatory Major Total Joint Arthroplasty: The Future is Now!

  • Ambulatory Anesthesia (GP Joshi, Section Editor)
  • Published:
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Abstract

Purpose of Review

The rapidly growing demands for total joint arthroplasty and changes in healthcare have resulted in these surgical procedures being performed in an outpatient/short-stay setting.

Recent Findings

For these procedures to be performed safely on an outpatient basis, it is necessary to implement multidisciplinary, multimodal protocols that improve functional outcomes, enhance recovery, and reduce the need for hospitalization. These protocols include appropriate patient selection, preoperative optimization of comorbid conditions, and patient education. In addition, use of minimally invasive surgical techniques along with fast-track anesthesia techniques as well as aggressive nonopioid multimodal analgesia and aggressive postoperative nausea and vomiting prophylaxis is necessary. Postoperatively, the focus is on early mobilization and accelerated physical therapy.

Summary

Collectively, these fast-track methods result in an effective clinical pathway that improves outcomes and the patient experience. The purpose of this review article is to examine the perioperative considerations required for performing total hip and knee arthroplasties on an outpatient basis.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9068, USA

    Asif Khan & Girish P. Joshi

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  1. Asif Khan
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  2. Girish P. Joshi
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Correspondence to Girish P. Joshi.

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Asif Khan declares that he has no conflict of interest.

Girish P. Joshi has received honoraria from Baxter, Merck, Pacira, and Mallinckrodt Pharmaceuticals.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Ambulatory Anesthesia.

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Khan, A., Joshi, G.P. Anesthesia for Ambulatory Major Total Joint Arthroplasty: The Future is Now!. Curr Anesthesiol Rep 6, 362–369 (2016). https://doi.org/10.1007/s40140-016-0180-7

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  • DOI: https://doi.org/10.1007/s40140-016-0180-7

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