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 methods
• Pre- and postoperative management
• How to select a needle injection location
• The benefits of combining the LIA technique with the drugs Naropin, Marcain, and Xylocaine

Color images throughout the text highlight the advantages of LIA, including:

• avoidance of sedation
• simple execution for physicians
• reduced risk of infection and blood clots
• little physiological disturbance
• earlier patient discharge and return to the workforce
• improved patient performance, outlook, and mobility
• fewer medical expenses