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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.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999