Novel Methodologies in Regional Anesthesia for Knee Arthroplasty

Abstract

Maximizing analgesia is critical following joint arthroplasty because postoperative pain is a major barrier to adequate physical therapy. Continuous peripheral nerve blocks have been the mainstay for acute pain management in this population; however, this and similar techniques are limited by their duration of action. Cryoneurolysis and peripheral nerve stimulation are two methodologies used for decades to treat chronic pain. With the advent of portable ultrasound devices and percutaneous administration equipment, both procedures may now be suitable for treatment of acute pain. This article reviews these two modalities and their application to joint arthroplasty.

Keywords: Cryoanalgesia; Cryoneurolysis; Knee arthroplasty; Neuromodulation; Peripheral nerve stimulation.