• Maria Fernanda Arboleda, Laura Girón-Arango, and Peng Philip W H PWH Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada..
• Clinique Santé Cannabis, Montreal, Quebec, Canada.
• Curr Opin Anaesthesiol. 2019 Oct 1; 32 (5): 661-667.

Purpose Of ReviewThis article discussed how the knowledge and technique of a few chronic pain procedures benefited the perioperative clinicians in their care of patients receiving specific orthopaedic surgical procedures.Recent FindingsRecent emerging interest in hip and knee denervation for chronic pain management secondary to osteoarthritis stimulates publications on the new understanding of hip and knee joint innervation. The improved understanding of the anatomy allows better precision in targeting the articular branches. The procedures for chronic joint pain such as radiofrequency ablation, chemical neurolysis and neuromodulation procedure have recently been applied to the perioperative care in orthopaedic procedures because of the potential long-lasting analgesia, opioid-sparing effect and consequent improvement in physical function and health-related quality of life after surgery.SummaryDespite the widespread use of regional anaesthesia and multimodal analgesia in the perioperative pain management, more than two-third of the patients reported severe postoperative pain. Therefore, other therapeutic strategies used in chronic pain management such as radiofrequency ablation and neuromodulation have been proposed to optimize acute postsurgical pain. The early experience with those techniques is encouraging, and more studies are required to explore the incorporation of these procedures in the perioperative care.

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