title: A prospective, randomized comparison between the popliteal and subgluteal approaches for continuous sciatic nerve block with stimulating catheters.
abstract: In this prospective, blinded study, we randomized 56 patients undergoing hallux valgus repair to receive continuous sciatic nerve block using a subgluteal (n = 28) or a posterior popliteal approach (n = 28) with a perineural stimulating catheter. Postoperatively, the stimulating catheter was connected to a patient-controlled analgesia pump with 0.0625% levobupivacaine (basal infusion rate of 3 mL/h, patient-controlled bolus dose of 3 mL, and lockout time of 20 min). Both approaches provided similar postoperative analgesia; however, local anesthetic consumption was larger in the popliteal group (4.9 +/- 1.4 mL/h) compared with the subgluteal group (3.8 +/- 1.1 mL/h; P < 0.05). We conclude continuous postoperative analgesia using stimulating catheters was effective at both injection sites; however, a subgluteal approach reduced the overall amount of local anesthetic.
authors.affiliation: University of Santiago de Compostela, Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Spain. manutabo@yahoo.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Taboada
authors.forename: Jaime
authors.initials: J
authors.lastname: Rodríguez
authors.forename: Cristina
authors.initials: C
authors.lastname: Valiño
authors.forename: Miriam
authors.initials: M
authors.lastname: Vazquez
authors.forename: Araceli
authors.initials: A
authors.lastname: Laya
authors.forename: Manuel
authors.initials: M
authors.lastname: Garea
authors.forename: Javier
authors.initials: J
authors.lastname: Carceller
authors.forename: Julian
authors.initials: J
authors.lastname: Alvarez
authors.forename: Vanessa
authors.initials: V
authors.lastname: Atanassoff
authors.forename: Peter G
authors.initials: PG
authors.lastname: Atanassoff
mesh_terms: D016058:Analgesia, Patient-Controlled; D000779:Anesthetics, Local; D002045:Bupivacaine / Q000031:analogs & derivatives; D002404:Catheterization / Q000379:methods*; D004311:Double-Blind Method; D004558:Electric Stimulation; D050488:Hallux Varus; D006801:Humans; D000077554:Levobupivacaine; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain; D012584:Sciatic Nerve
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine