By Scott M. Morrell, MD
Use reduces pain but may have toxic consequences
In many surgical specialties, the successful outcomes of ambulatory surgery have been attributed to various factors, not the least of which is successful postoperative pain control. The nature of many orthopaedic surgical procedures results in levels of postoperative pain that previously required hospital admission, overnight stays, or extended outpatient recovery. The development of less invasive surgical procedures and techniques, coupled with an increased awareness of the complexity of postoperative pain, has led to successful ambulatory surgery outcomes. The use of local anesthetics delivered by continuous infusion into or around surgical wounds has further enhanced the outpatient surgical experience for patients.