Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery: a randomized controlled double-blinded magnetic resonance imaging study
Autor: | Erik Morre Pedersen, Thomas Fichtner Bendtsen, Frank Linde, K. Kibak, Jens Børglum, Rasmus W. Hauritz, S. Bjoern |
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Rok vydání: | 2016 |
Předmět: |
Male
Nerve Block/methods medicine.medical_treatment sciatic nerve Magnetic Resonance Imaging Interventional 0302 clinical medicine 030202 anesthesiology Anesthetics Intravenous/administration & dosage postoperative magnetic resonance imaging pain Ropivacaine Orthopedic Procedures Prospective Studies Pain Postoperative Catheter insertion Nerve Block anaesthesia Middle Aged Sciatic Nerve Catheter medicine.anatomical_structure anaesthesia local ankle magnetic resonance imaging pain postoperative sciatic nerve postoperative analgesia perineural catheters regional anesthesia interscalene block paraneural sheath ultrasound complications dexamethasone dislocation insertion Anesthesiology Foot/surgery Ankle/surgery Female Sciatic nerve Anesthetics Intravenous medicine.drug Adult medicine.medical_specialty Catheters Popliteal Vein Amides/administration & dosage Pain Postoperative/drug therapy Magnetic Resonance Imaging Interventional/methods Young Adult 03 medical and health sciences Double-Blind Method Popliteal vein ankle local Journal Article medicine Humans Popliteal Vein/diagnostic imaging Aged Foot business.industry fungi Foot and ankle surgery Amides Surgery Sciatic Nerve/diagnostic imaging Anesthesiology and Pain Medicine Nerve block Ankle business 030217 neurology & neurosurgery |
Zdroj: | Wulff Hauritz, R, Pedersen, E M, Linde, F S, Kibak, K, Børglum, J, Frahm Bjørn, S & Bendtsen, T F 2016, ' Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery : A randomized controlled double-blinded magnetic resonance imaging study ', British Journal of Anaesthesia, vol. 117, no. 2, pp. 220-227 . https://doi.org/10.1093/bja/aew172 Hauritz, R W, Pedersen, E M, Linde, F S, Nielsen, K K, Børglum, J, Bjørn, S & Bendtsen, T F 2016, ' Displacement of popliteal sciatic nerve catheters after major foot and ankle surgery: a randomized controlled double-blinded magnetic resonance imaging study ', British Journal of Anaesthesia, vol. 117, no. 2, pp. 220-7 . https://doi.org/10.1093/bja/aew172 |
ISSN: | 0007-0912 |
Popis: | BACKGROUND: Popliteal sciatic nerve catheters (PSNCs) are associated with a high frequency of displacement. We aimed to estimate the frequency of catheter displacement after 48 h with magnetic resonance imaging (MRI) in patients with PSNCs after major foot and ankle surgery randomized to catheter insertion either with a short-axis in-plane (SAX-IP) approach perpendicular to the nerve or with a short-axis out-of-plane (SAX-OOP) approach parallel to the nerve.METHODS: Forty patients were randomly allocated to SAX-IP or SAX-OOP PSNC. Ropivacaine 0.75% 20 ml was injected via the catheter followed by ropivacaine 0.2% 10 ml h(-)1 infusion. Correct primary catheter placement was ensured after initial injection of local anaesthetic via the catheter. Forty-eight hours after insertion, MRI was performed after injection of saline with added contrast (Dotarem) via the catheter. The primary outcome was catheter displacement estimated as the frequency of spread of contrast exclusively outside the paraneurium.RESULTS: All patients had correct primary catheter placement. The frequency of displacement 48 h after insertion of the PSNC was 40% when inserted perpendicular to the nerve vs 10% parallel to the nerve (difference was 30 percentage points, 95% CI: 3-53 percentage points). The relative risk of displacement was four times larger (95% CI: 0.8-10, PCONCLUSION: Popliteal sciatic nerve catheters for major foot and ankle surgery inserted with ultrasound guidance parallel to the sciatic nerve have a significantly lower frequency of displacement compared with those inserted perpendicular to the nerve.CLINICAL TRIAL REGISTRATION: NCT02200016. |
Databáze: | OpenAIRE |
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