A "new" automated bolus technique for continuous popliteal block: a prospective, randomized comparison with a continuous infusion technique.
BACKGROUND
We designed the present, prospective, randomized, double-blind study to compare the administration of an automated intermittent bolus dose with a conventional technique of continuous infusion of local anesthetic for postoperative analgesia in continuous popliteal sciatic nerve blockade.


METHODS
Forty-four patients undergoing hallux valgus repair were randomly assigned to receive either a continuous infusion of 0.125% levobupivacaine with an infusion rate of 5 mL/h (continuous infusion group, n=22) or automated bolus doses of 5 mL every hour of the same local anesthetic (automated bolus group, n=22) for 24 h. Postoperative pain scores were assessed using a verbal rating pain score. The amount of rescue tramadol medication for pain was also recorded.


RESULTS
In patients of the automated bolus group there was a reduction in pain scores (P<0.05) during the postoperative period, when compared to patients of the continuous infusion group. Five patients in the automated bolus group (24%) and 11 patients of the continuous group (52%) required rescue tramadol analgesia (P=0.055).


CONCLUSIONS
The present investigation demonstrated that local anesthetic administered by an automated bolus technique provided better postoperative pain relief than a continuous infusion technique for continuous popliteal nerve block after foot surgery.
Taboada
Manuel
M
Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Travesía da Choupana s/n. 15706 Santiago de Compostela, Spain. manutabo@yahoo.es
Rodríguez
Jaime
J
Bermudez
Maria
M
Valiño
Cristina
C
Ulloa
Beatriz
B
Aneiros
Francisco
F
Gude
Francisco
F
Cortés
Joaquín
J
Alvarez
Julian
J
Atanassoff
Peter G
PG
D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004311:Double-Blind Method; D005260:Female; D006215:Hallux Valgus / Q000601:surgery; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D012584:Sciatic Nerve
D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine