Major complications after 400 continuous popliteal sciatic nerve blocks for post-operative analgesia.
BACKGROUND
A continuous popliteal sciatic nerve block (CPSNB) has been performed with increasing frequency for post-operative analgesia after foot surgery. Major complications associated with the placement of a perineural catheter remain rarely studied. The aim of this study was to prospectively determine the incidence of major complications (neurological and infectious) in post-operative adult patients with a continuous popliteal catheter inserted by the anatomical posterior approach for analgesia after foot surgery.


METHODS
All popliteal catheters were placed pre-operatively under sterile conditions with the aid of a nerve stimulator technique. The primary outcome measure was the incidence of major complications including infection and neuropathy. As a secondary outcome, adverse effects as well as other complications were also evaluated. Data were expressed as median [25th-75th percentiles].


RESULTS
A total of 400 patients were included in the study during a 2-year period. The median time the catheter remained indwelling was 47 h [23, 54]. Major complications included three events (0.75%) with one infection (0.25%) and two neuropathies (0.50%). Three blocks were unsuccessful and the catheter insertion was difficult in 12 patients (3%). During the CPSNB procedure, one patient reported slight paraesthesia during stimulation. Patient satisfaction was scored at 4 for 89%, 3 for 6% and 2 for 5% on the analogue scale.


CONCLUSIONS
Major complications after the use of CPSN are not in fact rare. The incidence of severe neuropathy or infection complications is, respectively, 0.50% and 0.25%. However, the insertion of CPSN could be considered effective and is associated with only a few minor complications.
Compère
V
V
Department of Anaesthetics and Intensive Care, Rouen University Hospital, Rouen, France. Vincent.Compere@chu-rouen.fr
Rey
N
N
Baert
O
O
Ouennich
A
A
Fourdrinier
V
V
Roussignol
X
X
Beccari
R
R
Dureuil
B
B
D000328:Adult; D000698:Analgesia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy*; D011183:Postoperative Complications