Comparison of continuous infusion versus automated bolus for postoperative patient-controlled analgesia with popliteal sciatic nerve catheters.

Abstract

BACKGROUND:

This investigation was designed to compare a new methodology of automated regular bolus with a continuous infusion of local anesthetic for continuous popliteal sciatic block; both regimens were combined with patient-controlled analgesia (PCA).

METHODS:

Fifty patients undergoing hallux valgus repair were randomly allocated to receive an infusion of 0.125% levobupivacaine administered through a popliteal catheter as an automated regular bolus (n = 25) or as a continuous infusion (n = 25), both combined with PCA. Postoperative pain scores, incremental doses delivered by the PCA, local anesthetic consumed per hour, and the need for rescue tramadol analgesia were recorded.

RESULTS:

Both dosing regimens provided similar postoperative analgesia. Consumption of local anesthetic (5.14 ml/h, 5-5.75 ml/h) and dose request from the PCA (1, 0-5.4) was lower in the automated bolus group as compared to the continuous infusion group (5.9 ml/h, 5.05-7.8 ml/h; doses by PCA: 6.5, 0-20.5; P < 0.05). The need for rescue tramadol was similar in the two groups.

CONCLUSION:

In continuous popliteal sciatic block, local anesthetic administered as an automated regular bolus in conjunction with PCA provided similar pain relief as a continuous infusion technique combined with PCA; however, the new dosing regimen reduced the need for additional PCA and the overall consumption of local anesthetic.

• Authors: Manuel Taboada, Jaime Rodríguez, Maria Bermudez, Marcos Amor, Beatriz Ulloa, Francisco Aneiros, Sergi Sebate, Joaquin Cortés, Julian Alvarez, Peter G Atanassoff
• Journal: Anesthesiology (Anesthesiology) Vol. 110 Issue 1 Pg. 150-4 (Jan 2009) ISSN: 1528-1175 [Electronic] United States
• PMID: 19104182 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anesthetics, Local

Topics

• Adult
• Aged
• Analgesia, Patient-Controlled (instrumentation, methods)
• Anesthetics, Local (administration & dosage)
• Catheters, Indwelling
• Double-Blind Method
• Female
• Humans
• Infusion Pumps
• Infusions, Intravenous
• Male
• Middle Aged
• Pain Measurement (drug effects, instrumentation, methods)
• Pain, Postoperative (physiopathology, prevention & control)
• Peroneal Nerve (drug effects, physiology)
• Prospective Studies
• Sciatic Nerve (drug effects, physiology)