title: [Sciatic perineural catheters: an alternative analgesia for diabetic patients].
abstract: BACKGROUND
  Patients with diabetes mellitus have chronic neuropathic pain. The aim of our study was to 1) evaluate the feasibility of providing analgesia with a long-term sciatic perineural catheter in a medical unit for diabetic patients and 2) evaluate its effectiveness.
  
  
  METHODS
  A prospective, monocentric, non-randomized study was conducted over two years. All diabetic patients with an ineffective optimal systemic treatment were included. Written consent was obtained. Popliteal-sciatic nerve catheters were inserted under ultrasound guidance; ropivacaine was started. The primary endpoint was pain at Day 2. Pain intensity was measured using a numeric rating scale (NRS). Secondary endpoints were patient's pain relief, the impact on quality of life, and morphine consumption, evaluated at Day 0, Day 2, at the time of catheter removal, and one month after catheter removal.
  
  
  RESULTS
  Feasibility was evaluated over one year. Fifty-five perineural catheters were placed in 32 patients. The median duration of catheter placement across patients was 13 [4-23] days. No toxic or infectious complications were seen. Effectiveness was evaluated during the second year of the study. Seventeen catheters were placed in 12 patients; 83% of patients had a NRS score ≤3 at Day 2. More than 70% of patients experienced pain relief while the catheter was in place and at one month after its removal. The impact on quality of life was negligible. Morphine consumption was less on Day 2, at the time of catheter removal and one month after removal.
  
  
  CONCLUSIONS
  The use of sciatic perineural catheters as an alternative analgesia technique in a non-surgical environment for diabetic patients with chronic pain was possible and effective.
authors.affiliation: Salle de Surveillance Post-Interventionnelle - Accueil des Polytraumatisés, Département d'Anesthésie - Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France. elodi.sch@wanadoo.fr.
authors.forename: Elodie
authors.initials: E
authors.lastname: Schaeffer
authors.affiliation: Salle de Surveillance Post-Interventionnelle - Accueil des Polytraumatisés, Département d'Anesthésie - Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Le Saché
authors.affiliation: Service de diabétologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bourron
authors.affiliation: Centre d'Évaluation et de Traitement de la Douleur, Groupe Hospitalier Pitié Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Collin
authors.affiliation: Salle de Surveillance Post-Interventionnelle - Accueil des Polytraumatisés, Département d'Anesthésie - Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Langeron
authors.affiliation: Salle de Surveillance Post-Interventionnelle - Accueil des Polytraumatisés, Département d'Anesthésie - Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Birenbaum
mesh_terms: D000368:Aged; D000698:Analgesia / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D012584:Sciatic Nerve