The Mayo Clinic total joint analgesic pathway
Peripheral nerve blocks are well described, but not universally accepted or utilised. In a national survey of 409 anaesthesiologists evaluating the use of peripheral nerve blocks, Hadzic et al.  reported that while nearly all respondents perform regional techniques, less that half performed more than five peripheral nerve blocks per month. Importantly, lower extremity blocks other than ankle blocks were seldom used. This is unfortunate, since lower extremity blocks have many advantages over neuraxial techniques and represent alternatives for both intraoperative anaesthesia and postoperative analgesia. Anaesthesiologists in Europe have already shifted their practice towards peripheral blocks. A prospective study of 103,730 regional anaesthetics performed in France over a 5-month period included 21,278 peripheral blocks.
KeywordsTotal Knee Arthroplasty Femoral Neck Fracture Postoperative Analgesia Femoral Nerve Block Peripheral Nerve Block
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