I was trained as and function as an anesthesiologist and have engaged in the practice of pain medicine part time/full time/part time again. It is unclear what you mean by "attitude", but if you are referring to my vast experience of 30 years coming across as pedantic, then I take that as a complement. As for being "off base" with respect to the TKA, the catheter method is how we currently deliver post op pain control after surgery and at home afterwards. With better pain control, surgery is being performed in outpatient centers rather than in hospitals. One of the surgery centers where I render anesthesia does 12 hour C1-2 fusions, open surgery multiple level lumbar fusions, and complex knee surgeries. Adequate post op pain control is increasingly important as what were traditionally hospital based surgeries move into the surgery center arena. Again, we may have different experiences, training, and level of comfort- but your opinion in your medical venue is valid for your patients, and I wouldn't suggest otherwise. I offered to the forum a method that works for me. It may not work for everyone due to surgeon idiosyncrasies, equipment availability, time elements involved in placing such a catheter, home instructions, etc.
