Levobupivacaine Consumption in Automated Intermittent Bolus in Ultrasound Guided Subparaneural Sciatic Nerve Catheters: A Prospective Double-Blind Randomized Trial

Levobupivacaine Consumption in Automated Intermittent Bolus in Ultrasound Guided Subparaneural Sciatic Nerve Catheters: A Prospective Double-Blind Randomized Trial

Blog Article

Margaretha B Breebaart,1,2 Jordi Branders,2 Luc Sermeus,3 Sultan Termurziev,2 Helene Camerlynck,2 Lennert Van Putte,1 Marnik Van Putte Minelli,1 Stefan De Hert4 1Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium; 2Department of Anesthesia, Antwerp University Hospital, Edegem, Belgium; 3Department of Anesthesiology, St.Luc University Hospital, Brussels, Belgium; 4Department of Anesthesia and Perioperative Medicine, Ghent University Hospital, Ghent, BelgiumCorrespondence: Margaretha B BreebaartDepartment of Anesthesia, Antwerp University Hospital, Wilrijkstraat 10, Edegem, 2650, BelgiumTel +32 486911691Email Margaretha.breebaart@uza.bePurpose: Continuous sciatic nerve blocks have proven benefits for postoperative analgesia after foot surgery.

However, the optimal mode of administration remains a point of debate.Ultrasound guided subparaneural injection accelerates onset time and increases duration after a single shot sciatic nerve block.This double blind prospective randomized trial compares the 48-hour local anesthetic (LA) dose consumption of an automated intermittent bolus technique to a continuous infusion regimen in iphone 13 pro max price florida a subparaneural sciatic nerve catheter after hallux valgus surgery.Patients and Methods: Patients scheduled for hallux valgus surgery were randomized to receive either a continuous infusion of levobupivacaine 0.

125% at 5mL/h (group A) or an intermittent automated bolus of 9.8 mL every 2 hours with a background of 0.1 mL/h (group B), both with a PCA bolus of 6 mL and lockout of 30 minutes.The 48 hour LA consumption, PCA boluses, Numeric Rating Scale (NRS), satisfaction and return of normal sensation were recorded.

Results: Sixteen patients were excluded because of protocol violation or technical problems and 42 patients remained for analysis.The 48 hour ropivacaine consumption was higher in group A (293 ± 60 mL) than group B (257± 33 mL).The median and highest NRS scores and patient satisfaction were not statistically different between groups.Normal sensation returned after 75 ± 22 hours (group A) and 70 ± 17 hours (group B).

Conclusion: Programmed bolus administration in subparaneural sciatic nerve catheters reduces LA consumption 48 trucan b hours after surgery with equal analgesia and patient satisfaction.Return of sensation is variable and can last more than 75 hours.Keywords: locoregional anesthesia, sciatic nerve block, postoperative pain, local anesthetics, levobupivacaine, orthopedic surgery.