Anesthetic management in ERAS protocols for total knee and total hip arthroplasty: An integrative review
Laura Oseka, DNAP, CRNA
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Oseka, Laura by View
Popular Works for Oseka, Laura by Download
Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic and analgesic recommendations for inclusion in an enhanced recovery after surgery (ERAS) protocol for patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).
Methods: Articles published between 2006 and December 2016 were critically appraised for validity, reliability, and rigor of study.
Results: The administration of non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, gabapentinoids, and steroids result in shorter hospital length of stay (LOS) and decreased postoperative pain and opioid consumption. A spinal anesthetic block provides benefits over general anesthesia, such as decreased 30-day mortality rates, hospital LOS, blood loss, and complications in the hospital. The use of peripheral nerve blocks result in lower pain scores, decreased opioid consumption, fewer complications, and shorter hospital LOS.
Conclusion: Perioperative anesthetic management in ERAS protocols for TKA and THA patients should include the administration of acetaminophen, NSAIDs, gabapentinoids, and steroids. Preferred intraoperative anesthetic management in ERAS protocols should consist of spinal anesthesia with light sedation. Postoperative pain should be managed with peripheral nerve blocks such as adductor canal block or femoral nerve block supplemented with sciatic nerve block or local infiltrated anesthesia.
|Type||Other Graduate Paper|
|Review Type||Faculty Approved: Degree-based Submission|
|Evidence Level||Literature Review|
Enhanced Recovery after Surgery Protocols;
Total Knee Arthroplasty;
Total Hip Arthroplasty
Arthroplasty, Replacement, Hip;
Arthroplasty, Replacement, Knee;
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
The following license files are associated with this item:
Showing items related by title, author, creator and subjects.
The effects of post-operative pain management when comparing the Enhanced Recovery After Surgery (ERAS) to the traditional approach amongst patients undergoing general surgery Agboruche, Tia D.Chronic pain patients are vulnerable to developing addictions due to the long duration of high dose prescription narcotics. Consequently, optimal treatment approaches need to be identified for patients who are at high risk ...
Reiki as a pain management adjunct in the postoperative total knee arthroplasty and surgical obstetric population: An integrative review Knopes, AllisonPain is an undesirable, but anticipated component of surgery. Opioids are routinely administered to manage pain for the millions of surgical procedures performed annually in the United States. Given the rising rate of ...
Boer, Meghan (2017-06-26)Despite the lack of compelling evidence to support long-term efficacy in the treatment of opioid abuse, opioids are one of the most common classes of medications prescribed in the United States. As such, the significant ...
Implementing an integrative pre and post-operative educational intervention for older adults undergoing total hip and knee replacement Fox, Carolyn Marie (2015-01-15)Session presented on Friday, September 26, 2014: The purpose of this pilot project was to implement postoperative education in a select population of elderly patients undergoing THR or TKR in combination with the pre-operative ...
Mathew, J. M.Pain management was a concern for Total Knee Arthroplasty patients due to a high level of pain: Exparel, a piloted study conducted and has shown promise for TKA procedure. The plan is to implement to other VAs across the ...