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Continuous infusion versus single bolus popliteal block following major ankle and hindfoot surgery: a prospective, randomized trial.

AbstractBACKGROUND:
Popliteal sciatic nerve blockade is a commonly used technique employed in the management of postoperative pain following foot and ankle surgery. Recent studies have shown that for outpatient surgery, for moderately painful procedures, a continuous infusion of local anesthesia via an in-dwelling catheter for 48 to 72 hours leads to reduced opiate analgesic requirements and improved pain and patient satisfaction scores.
MATERIALS AND METHODS:
A prospective, randomized, double blind, placebo-controlled trial of a continuous infusion of bupivacaine verses normal saline via a popliteal catheter after a single bolus popliteal block for 72 hours after major ankle and hind foot surgery was performed in 54 patients.
RESULTS:
The average pain scores overall were low (range, 1.1 to 3.6 on a Visual Analogue Scale of 0 to 10) throughout the study period. Statistically significantly lower pain scores with significantly less requirement for supplementary opiate analgesic agents were seen in the treatment group.
CONCLUSION:
Despite the statistically significant findings, with such low pain scores in both groups, we believe it remains debatable whether the extra time and cost involved warrants the use of a continuous popliteal blockade over a single bolus injection.
AuthorsRobin Elliot, Christopher J Pearce, Chris Seifert, James Df Calder
JournalFoot & ankle international (Foot Ankle Int) Vol. 31 Issue 12 Pg. 1043-7 (Dec 2010) ISSN: 1071-1007 [Print] United States
PMID21189203 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Bupivacaine
Topics
  • Analgesics, Opioid (therapeutic use)
  • Anesthetics, Local (administration & dosage)
  • Ankle (surgery)
  • Bupivacaine (administration & dosage)
  • Double-Blind Method
  • Drug Utilization
  • Foot (surgery)
  • Humans
  • Infusions, Intravenous
  • Morphine (therapeutic use)
  • Nerve Block
  • Orthopedic Procedures
  • Pain Measurement
  • Pain, Postoperative (prevention & control)
  • Prospective Studies

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