A comparison of two different concentrations and infusion rates of ropivacaine in perineural infusion administered at the same total dose for analgesia after foot and ankle surgery: a randomized, double blinded, controlled study
| Autor: | Anna Maria Bombardieri, Richard L. Kahn, Kethy M Jules-Elysee, Gregory A Liguori, Yan Ma, Andrew R. Lee, Barbara Wukovits, A. Raffaele De Gaudio, James J. Bae, Daniel B Maalouf |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Adolescent medicine.drug_class law.invention Catheterization 03 medical and health sciences Basal (phylogenetics) Young Adult 0302 clinical medicine Randomized controlled trial Double-Blind Method 030202 anesthesiology law medicine Humans Ropivacaine Anesthetics Local Infusions Intravenous Aged Pain Measurement Aged 80 and over Pain Postoperative Local anesthetic business.industry Foot Incidence (epidemiology) Foot and ankle surgery 030208 emergency & critical care medicine Analgesia Patient-Controlled Nerve Block Middle Aged Catheter Anesthesiology and Pain Medicine Treatment Outcome Anesthesia Female Sciatic nerve Analgesia Ankle business medicine.drug |
| Zdroj: | Minerva anestesiologica. 85(2) |
| ISSN: | 1827-1596 |
| Popis: | Background Continuous popliteal nerve block is utilized for postoperative analgesia after foot and ankle surgery. Whether only the total dose of local anesthetic or the combination of concentration and volume determine the characteristics of a continuous popliteal nerve infusion remains currently unknown. We hypothesized a reduction of the incidence of insensate extremity in patients given ropivacaine 0.4% at 4 mL/h compared to patients given ropivacaine 0.2% at 8 mL/h. Methods Sixty-four patients scheduled for major foot and ankle surgery requiring a continuous popliteal catheter infusion for postoperative analgesia were studied. Thirty-three patients were randomized to receive a continuous popliteal nerve block with 0.2% (basal 8 mL/h) and thirty-one with 0.4% (basal 4 mL/h) ropivacaine, reaching the same total dose (16 mg/h). The primary outcome was the incidence of persistent sensory block in the distal sciatic nerve distributions in the postoperative period. Secondary outcomes were the incidence of motor block, NRS pain scores at rest in the postoperative period up to 48 hours after surgery, opioid use and related side effects, patients' satisfaction. Results The incidence of persistent sensory block was similar in patients given 0.2% and in patients receiving 0.4% ropivacaine. The incidence of motor block, postoperative pain scores at rest, use of oral opioids, side effects and patients' satisfaction with the quality of recovery were also similar in both groups. Conclusions Our results suggest that local anesthetic total dose is the primary determinant of continuous popliteal perineural infusion effects. |
| Databáze: | OpenAIRE |
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