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
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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