Postoperative analgesia with continuous sciatic nerve block after foot surgery: a prospective, randomized comparison between the popliteal and subgluteal approaches

Anesthesia and Analgesia
Pia di BenedettoJaques E Chelly

Abstract

To compare the posterior popliteal and subgluteal continuous sciatic nerve block for anesthesia and acute postoperative pain management after foot surgery, 60 ASA physical status I and II patients undergoing elective orthopedic foot surgery were randomly assigned to either a Subgluteal group (n = 30) or Popliteal group (n = 30). Before surgery and after performing a femoral nerve block with 15 mL of 2% mepivacaine, we performed the sciatic nerve block with 20 mL of 0.75% ropivacaine using either a subgluteal or posterior popliteal approach, and the placement of a catheter came afterward. In the recovery room, the catheter was connected to a patient-controlled analgesia pump to infuse 0.2% ropivacaine (basal infusion rate of 5 mL/h, incremental bolus of 10 mL, and a lockout time of 60 min). There were no technical problems in catheter placement. Intraoperative efficacy of nerve block was similar in the two groups. Postoperative catheter displacement and occlusion were recorded in four patients in the Popliteal group and two patients in the Subgluteal group (P = 0.67). Both approaches provided similar postoperative analgesia. We conclude that the subgluteal approach is as effective and safe as the previously described posterior p...Continue Reading

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References

Aug 1, 1994·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·D H McLeodP M Merrick
Feb 1, 1993·Anaesthesia and Intensive Care·M J Davies, D P McGlade
Jul 1, 1996·Foot & Ankle International·K RongstadG Horton
Dec 22, 1999·Anesthesiology·J E Chelly, L Delaunay
Mar 17, 2001·Regional Anesthesia and Pain Medicine·A ChoyceC J McCartney

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Citations

Oct 22, 2005·Paediatric Anaesthesia·Lakshmi Vas
Aug 20, 2009·Anesthesia and Analgesia·Christopher RobardsRoy Greengrass
Jun 23, 2006·Anesthesia and Analgesia·Alain BorgeatPatrick Vienne
Aug 9, 2011·Anesthesia and Analgesia·Brian M Ilfeld
Jun 23, 2005·International Anesthesiology Clinics·Shruti ShahAdmir Hadzic
Feb 18, 2005·Acta Anaesthesiologica Scandinavica·A Martínez NavasM Echevarría Moreno
Apr 14, 2010·Anaesthesia·S L Kopp, T T Horlocker
Oct 6, 2006·Current Opinion in Anaesthesiology·Paolo Grossi, William F Urmey
Jan 13, 2019·Regional Anesthesia and Pain Medicine·De Q TranJoseph M Neal
Nov 3, 2007·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·De Quang Hieu TranRoderick J Finlayson

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