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Optimizing dose infusion of 0.125% bupivacaine for continuous femoral nerve block after total knee replacement.
MedLine Citation:
PMID:  20532056     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The optimal dose infusion of 0.125% bupivacaine via a femoral catheter after total knee replacement (TKR) has not been defined. This study examined various dose infusions of bupivacaine to determine the analgesic quality in patients receiving a continuous femoral nerve block (CFNB).
METHODS: Patients were randomized to receive a single-injection femoral nerve block (SFNB) or CFNB performed with 20 ml of 0.125% bupivacaine, followed by a continuous infusion of 0.125% bupivacaine in four groups (n = 20 per group): 1) 0 ml/h (SFNB), 2) 2 ml/h, 3) 4 ml/h, and 4) 6 ml/h. The pain intensity at rest and on knee movement was assessed using a visual analog scale (VAS) for the first 2 postoperative days. The cumulative bolus use of IV patientcontrolled analgesia (PCA) with a morphine-ketorolac combination was evaluated.
RESULTS: A lower cumulative bolus of IV PCA was noted in all CFNB groups compared to SFNB on postoperative days (PODs) 1 and 2, respectively (P < 0.05). Lower VAS scores at rest were observed in the 4 ml/h and 6 ml/h groups than in the SFNB group on PODs 1 and 2, respectively, but only on POD 2 in the 2 ml/h group (P < 0.05). Lower VAS scores on movement were noted in the 4 ml/h than the SFNB group on PODs 1 and 2, but only on POD 1 in 6 ml/h (P < 0.05).
CONCLUSIONS: The minimum effective infusion rate of 0.125% bupivacaine for CFNB after TKR appears to be 4 ml/h according to the VAS pain scores.
Authors:
Chang Kil Park; Choon Kyu Cho; Gang Geun Lee; Jong Hyuk Lee
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Publication Detail:
Type:  Journal Article     Date:  2010-05-29
Journal Detail:
Title:  Korean journal of anesthesiology     Volume:  58     ISSN:  2005-7563     ISO Abbreviation:  Korean J Anesthesiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101502451     Medline TA:  Korean J Anesthesiol     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  468-76     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Pain Medicine, College of Medicine, Eulji University, Daejeon, Korea.
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