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Anesthesia and Analgesia Practice Pathway Options for Total Knee Arthroplasty: An Evidence-Based Review by the American and European Societies of Regional Anesthesia and Pain Medicine
  1. Sandra L. Kopp, MD*,
  2. Jens Børglum, MD, PhD,
  3. Asokumar Buvanendran, MD,
  4. Terese T. Horlocker, MD§,
  5. Brian M. Ilfeld, MD, MS (Clinical Investigation)**,
  6. Stavros G. Memtsoudis, MD, PhD, FCCP††,
  7. Joseph M. Neal, MD‡‡,
  8. Narinder Rawal, MD, PhD, FRCA (Hon), EDRA§§ and
  9. Jessica T. Wegener, MD, PhD, EDRA∥∥
  1. *Department of Anesthesiology, Mayo Clinic, Rochester, MN; †Department of Anesthesiology and Intensive Care Medicine, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark; ‡Department of Anesthesiology, Rush University Medical Center, Chicago, IL; Departments of §Anesthesiology and ∥Orthopedics, Mayo Clinic, Rochester, MN; **Department of Anesthesiology, University of California, San Diego, CA; ††Department of Anesthesiology, Weill Cornell Medical College, Hospital for Special Surgery, New York, NY; ‡‡Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA; §§Department of Anaesthesiology and Intensive Care, Örebro University, Örebro, Sweden; and ∥∥Department of Anaesthesiology, Pain Medicine and Palliative Care, University Hospital of Amsterdam, Amsterdam, the Netherlands
  1. correspondence: Sandra L. Kopp, MD, Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (e-mail: kopp.sandra{at}


Abstract In 2014, the American Society of Regional Anesthesia and Pain Medicine in collaboration with the European Society of Regional Anaesthesia and Pain Therapy convened a group of experts to compare pathways for anesthetic and analgesic management for patients undergoing total knee arthroplasty in North America and Europe and to develop a practice pathway. This review is intended to be an analysis of the current literature to assist individuals and institutions in designing a pathway for total knee arthroplasty that is based on existing evidence and expert recommendation and may be customized according to individual settings.

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  • B.M.I.'s institution has received funding for his research from several infusion pump manufacturers, including Baxter Healthcare, Smiths Medical, Infutronix, and Summit Medical; a perineural catheter manufacturer, Teleflex Medical; a manufacturer of a peripheral nerve stimulator, SPR Therapeutics; a manufacturer of a cryoneurolysis device, Myoscience; and manufacturers of long-acting liposome bupivacaine formulations, Pacira Pharmaceuticals, and Heron Therapeutics. The other authors declare no conflict of interest.