This Article Full Text Full Text (PDF) An erratum has been published Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ilfeld, B. M. Articles by Vandenborne, K. Search for Related Content PubMed PubMed Citation Articles by Ilfeld, B. M. Articles by Vandenborne, K.

---

AMBULATORY ANESTHESIA

Total Knee Arthroplasty as an Overnight-Stay Procedure Using Continuous Femoral Nerve Blocks at Home: A Prospective Feasibility Study

Brian M. Ilfeld, MD, MS^*, Peter F. Gearen, MD, F. Kayser Enneking, MD^*, Linda F. Berry, RN, Eugene H. Spadoni, PT, Steven Z. George, PhD, PT, and Krista Vandenborne, PhD, PT

*Departments of Anesthesiology, Orthopaedics and Rehabilitation, and Physical Therapy, University of Florida, Gainesville, Florida

Address correspondence and reprint requests to Brian M. Ilfeld, MD, Department of Anesthesiology, P.O. Box 100254, 1600 SW Archer Road, Gainesville, FL 32610-0254. Address e-mail to bilfeld{at}ulf.edu.

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.

This article has been cited by other articles:

				E. R. Mariano, V. J. Loland, N. S. Sandhu, R. H. Bellars, M. L. Bishop, R. Afra, S. T. Ball, R. S. Meyer, R. C. Maldonado, and B. M. Ilfeld Ultrasound Guidance Versus Electrical Stimulation for Femoral Perineural Catheter Insertion J. Ultrasound Med., November 1, 2009; 28(11): 1453 - 1460. [Abstract] [Full Text] [PDF]

				B. M. Ilfeld, R. S. Meyer, L. T. Le, E. R. Mariano, B. A. Williams, K. Vandenborne, P. W. Duncan, D. I. Sessler, F. K. Enneking, J. J. Shuster, et al. Health-Related Quality of Life After Tricompartment Knee Arthroplasty With and Without an Extended-Duration Continuous Femoral Nerve Block: A Prospective, 1-Year Follow-Up of a Randomized, Triple-Masked, Placebo-Controlled Study Anesth. Analg., April 1, 2009; 108(4): 1320 - 1325. [Abstract] [Full Text] [PDF]

				H.-N. Pang, N.-N. Lo, K.-Y. Yang, H.-C. Chong, and S.-J. Yeo Peri-articular steroid injection improves the outcome after unicondylar knee replacement: A PROSPECTIVE, RANDOMISED CONTROLLED TRIAL WITH A TWO-YEAR FOLLOW-UP J Bone Joint Surg Br, June 1, 2008; 90-B(6): 738 - 744. [Abstract] [Full Text] [PDF]

				C. R.K. Grant and M. R. Checketts Analgesia for primary hip and knee arthroplasty: the role of regional anaesthesia CEACCP, April 1, 2008; 8(2): 56 - 61. [Full Text] [PDF]

				D. Zaric, K. Boysen, C. Christiansen, J. Christiansen, S. Stephensen, and B. Christensen Combined Femoral-Sciatic Catheters for Postoperative Pain Treatment After Total Knee Replacement Anesth. Analg., July 1, 2007; 105(1): 288 - 289. [Full Text] [PDF]

				J. E. Chelly and B. Ben-David Do Continuous Femoral Nerve Blocks Affect the Hospital Length of Stay and Functional Outcome? Anesth. Analg., April 1, 2007; 104(4): 996 - 997. [Full Text] [PDF]

				F. V. Salinas Do Continuous Femoral Nerve Blocks Affect the Hospital Length of Stay and Functional Outcome? Anesth. Analg., April 1, 2007; 104(4): 997 - 998. [Full Text] [PDF]

				H. Kehlet Postoperative Analgesia and Hospital Stay: A Call for Better Study Design Anesth. Analg., January 1, 2007; 104(1): 212 - 212. [Full Text] [PDF]

				F. V. Salinas Postoperative Analgesia and Hospital Stay: A Call for Better Study Design Anesth. Analg., January 1, 2007; 104(1): 212 - 213. [Full Text] [PDF]