title: Comparison of continuous infusion versus automated bolus for postoperative patient-controlled analgesia with popliteal sciatic nerve catheters.
abstract: 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.
authors.affiliation: University of Santiago de Compostela, and 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: Maria
authors.initials: M
authors.lastname: Bermudez
authors.forename: Marcos
authors.initials: M
authors.lastname: Amor
authors.forename: Beatriz
authors.initials: B
authors.lastname: Ulloa
authors.forename: Francisco
authors.initials: F
authors.lastname: Aneiros
authors.forename: Sergi
authors.initials: S
authors.lastname: Sebate
authors.forename: Joaquin
authors.initials: J
authors.lastname: Cortés
authors.forename: Julian
authors.initials: J
authors.lastname: Alvarez
authors.forename: Peter G
authors.initials: PG
authors.lastname: Atanassoff
mesh_terms: 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
chemical_list: D000779:Anesthetics, Local