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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 methodsPre- and postoperative managementHow to select a needle injection locationThe benefits of combining the LIA technique with the drugs Naropin, Marcain, and XylocaineColor images throughout the text highlight the advantages of LIA, including:
avoidance of sedationsimple execution for physiciansreduced risk of infection and blood clotslittle physiological disturbanceearlier patient discharge and return to the workforceimproved patient performance, outlook, and mobilityfewer medical expenses