Comparison of continuous infusion versus automated bolus for postoperative patient-controlled analgesia with popliteal sciatic nerve catheters.
BACKGROUND
This investigation was designed to compare a new methodology of automated regular bolus with a continuous infusion of local anesthetic for continuous popliteal sciatic block; both regimens were combined with patient-controlled analgesia (PCA).


METHODS
Fifty patients undergoing hallux valgus repair were randomly allocated to receive an infusion of 0.125% levobupivacaine administered through a popliteal catheter as an automated regular bolus (n = 25) or as a continuous infusion (n = 25), both combined with PCA. Postoperative pain scores, incremental doses delivered by the PCA, local anesthetic consumed per hour, and the need for rescue tramadol analgesia were recorded.


RESULTS
Both dosing regimens provided similar postoperative analgesia. Consumption of local anesthetic (5.14 ml/h, 5-5.75 ml/h) and dose request from the PCA (1, 0-5.4) was lower in the automated bolus group as compared to the continuous infusion group (5.9 ml/h, 5.05-7.8 ml/h; doses by PCA: 6.5, 0-20.5; P < 0.05). The need for rescue tramadol was similar in the two groups.


CONCLUSIONS
In continuous popliteal sciatic block, local anesthetic administered as an automated regular bolus in conjunction with PCA provided similar pain relief as a continuous infusion technique combined with PCA; however, the new dosing regimen reduced the need for additional PCA and the overall consumption of local anesthetic.
Taboada
Manuel
M
University of Santiago de Compostela, and Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Spain. manutabo@yahoo.es
Rodríguez
Jaime
J
Bermudez
Maria
M
Amor
Marcos
M
Ulloa
Beatriz
B
Aneiros
Francisco
F
Sebate
Sergi
S
Cortés
Joaquin
J
Alvarez
Julian
J
Atanassoff
Peter G
PG
D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000295:instrumentation / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002408:Catheters, Indwelling; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects / Q000295:instrumentation / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D010543:Peroneal Nerve / Q000187:drug effects / Q000502:physiology; D011446:Prospective Studies; D012584:Sciatic Nerve / Q000187:drug effects* / Q000502:physiology
D000779:Anesthetics, Local