Document Detail


Continuous popliteal sciatic nerve block for outpatient foot surgery--a randomized, controlled trial.
MedLine Citation:
PMID:  14982567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A major problem in outpatient foot surgery is severe postoperative pain that is not sufficiently treated by peroral analgesics. METHODS: Sixty-three patients underwent foot surgery under spinal anesthesia. Immediately on conclusion of the operation, sciatic and saphenous nerve blocks were performed. The sciatic nerve was blocked in the popliteal fossa with 30 ml of ropivacaine 5 mg ml(-1) and a perineural catheter was passed through the cannula. The patients were randomized to receive either ropivacaine 2 mg ml(-1) (n=30) or saline (n=30) in the catheter through a disposable elastomeric pump with a fixed infusion rate of 5 ml h(-1) for 55 h. RESULTS: Analgesia was excellent until 23 h 44 min (14 h 34 min) in the treatment group and 18 h 16 min (7 h) in the placebo group [mean (SD), P=0.07]. Thereafter, pain was significantly less in the treatment group on the first and second postoperative days (P=0.001). Sleep disturbances because of the pain in the foot were experienced by 25% of the treatment group on the first night at home and by 50% of the control group (P=0.29). There were no differences between the groups in their need for rescue opioid medication. None of the patients had any major problem with the catheter or pump, and none had any toxic effect referable to the technique. CONCLUSION: This randomized, double-blind study shows that continuous blockade of the sciatic nerve in the popliteal fossa reduces postoperative pain and has no untoward effects in a patient group known to experience severe pain after ambulatory surgery.
Authors:
D Zaric; K Boysen; J Christiansen; U Haastrup; H Kofoed; N Rawal
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  48     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-25     Completed Date:  2004-06-21     Revised Date:  2005-02-07    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  337-41     Citation Subset:  IM    
Affiliation:
Departmtent of Anesthesiology, Frederiksberg Hospital, University of Copenhagen, Denmark. zaricdus@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Surgical Procedures*
Amides / administration & dosage
Anesthesia, Spinal
Anesthetics, Local / administration & dosage
Double-Blind Method
Female
Follow-Up Studies
Foot / surgery*
Humans
Infusion Pumps
Knee / innervation
Male
Middle Aged
Nerve Block / methods*
Pain Measurement
Pain, Postoperative / prevention & control*
Patient Satisfaction
Placebos
Sciatic Nerve*
Sleep / drug effects
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Amides; 0/Anesthetics, Local; 0/Placebos; 84057-95-4/ropivacaine
Comments/Corrections
Comment In:
Acta Anaesthesiol Scand. 2004 Nov;48(10):1342-3; author reply 1343   [PMID:  15504200 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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