title: The efficacy comparison of on-demand boluses with and without basal infusion of 0.1 % bupivacaine via perineural femoral catheter after arthroscopic ACL reconstruction.
abstract: OBJECTIVE
  Optimal postoperative analgesia after anterior cruciate ligament repair remains challenging. The objective of this prospective experimental clinical study was to compare the postoperative analgesic efficacy of two infusion regimens of 0.1 % bupivacaine administered via perineural femoral catheter.
  
  
  METHODS
  Forty adult ASA I and II patients undergoing anterior cruciate ligament reconstruction were enrolled. Surgery was performed under spinal anesthesia combined with femoral nerve block. A perineural femoral catheter was connected to the patient controlled analgesia infusion pump filled with 0.1 % bupivacaine for postoperative pain control. Subjects were assigned to one of two groups according to the bupivacaine infusion regimen: (1) 5 mL/h basal infusion with on-demand 5 mL boluses and 30-min refractive periods, and (2) only on-demand 5 mL boluses and 15-min refractive periods. Quality of postoperative analgesia, adjunctive analgesic consumption, and overall patient satisfaction were recorded for 48 h.
  
  
  RESULTS
  Pain control was better in Group I on the day of surgery (P = 0.001) and on the first postoperative day at rest and during mobilization (P = 0.02 and P = 0.009). On the second postoperative day, only pain control during mobilization was better in Group I (P = 0.047). Adjunctive analgesic consumption and patient satisfaction were similar.
  
  
  CONCLUSIONS
  Perineural femoral infusion of on-demand 5 mL boluses of 0.1 % bupivacaine combined with 5 mL/h basal infusion was more efficient than on-demand regimen alone for postoperative pain management after reconstruction of anterior cruciate ligament of the knee.
  
  
  METHODS
  II.
authors.affiliation: Clinic of Anesthesiology and Intensive Care, Vilnius University, Siltnamių 29, LT-04130, Vilnius, Lithuania. saule.svediene@mf.vu.lt
authors.forename: Saule
authors.initials: S
authors.lastname: Svediene
authors.forename: Audrius
authors.initials: A
authors.lastname: Andrijauskas
authors.forename: Juozas
authors.initials: J
authors.lastname: Ivaskevicius
authors.forename: Andrius
authors.initials: A
authors.lastname: Saikus
mesh_terms: D000293:Adolescent; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000779:Anesthetics, Local / Q000008:administration & dosage*; D059549:Anterior Cruciate Ligament Reconstruction; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage*; D002404:Catheterization; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine