Regional anesthesia for knee surgery

Knee surgery may be performed under general anesthesia, preferably, however, under regional anesthesia because of the profound preemptive analgesic effect that is provided by regional anesthetic techniques. Both centroneuraxis (spinal, epidural) as well as peripheral nerve blocks may be used for knee surgery. Although the former may be used less frequently in the near future in knee surgery because of increasing administration of low molecular heparins with resultant epidural hematoma formation, the latter enjoy more and more popularity. Peripheral nerve blocks used mostly for knee surgery include femoral/sciatic nerve blocks and intra-articular injection of local anesthetics and/or opioids into the knee joint. They are devoid of extensive sympathectomy and provide sufficient surgical analgesia and motor block.