Local Infiltration Analgesia

The concept of integrating pain management into the surgical process as a single entity is new and exciting. The use of local anaesthetic to block post-operative pain at the site of its generation is here refined into a management program allowing early mobilisation and dramatic pain control in the early post-operative period. This multimodal technique is demonstrated here with application to lower limb arthroplasty and spinal surgery. This is not only a detailed explanation and instruction in the technique and concept, but a historical perspective on its development, and will be of great interest to all orthopaedic surgeons as well as anaesthetists. Using easy-to-understand terminology, this text covers: * LIA methods * pre- and postoperative management * how to select a needle injection location * the benefits of combining the LIA technique with the drugs Naropin, Marcain, and Xylocaine Color images throughout the text highlight the advantages of LIA, including: o avoidance of sedation o simple execution for physicians o reduced risk of infection and blood clots little physiological disturbance o earlier patient discharge and return to the workforce o improved patient performance, outlook, and mobility o fewer medical expenses Dennis Kerr MBBS, MHA, FANZCA, FFICANCA, DipABA, FHKCA, FHKAM, Joint Orthopaedic Centre Bondi Junction, New South Wales Australia , has over 20 years experience in anesthesia and intensive care. He is involved in pre-operative education, operative planning, and discharge patient care. CONTENTS * Foreword Lawrence Kohan * Preface 1 How It All Started * 2 Physiology and Anatomy * 3 Local Infiltration Analgesia * 4 Safety Issues * 5 Outcomes * 6 Thromboprophylaxis and Local Infiltration Analgesia * 7 Infection and Local Infiltration Analgesia * 8 Local Infiltration Analgesia for Lumbar Spine Surgery Peter J Papantoniou and Dennis R Kerr * 9 Postoperative Care * 10 Implementation – Making It Work * Appendix 1 – Ropivacaine * Appendix 2 – Local Anaesthetic Toxicity * Appendix 3 – Lipid Rescue Protocol * Appendix 4 – Patient Information Sheets * 4.1 Total Hip Replacement 4.2 Total Knee Replacement 4.3 Norspan 5 Skin Patches Appendix 5 – Staff Information * 5.1 Nursing protocols at St Luke’s Hospital for administration of local infiltration analgesia 5.2 Clinical policy manual at St George Private Hospital on administration and observations for local anaesthetic reinjection and topup: orthopaedic patients Index