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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2018 Apr 10

DOI: 10.23736/S0375-9393.18.12266-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

A comparison of two different concentrations and infusion rates of ropivacaine in perineural infusion administered at the same total dose for analgesia after foot and ankle surgery: a randomized, double blinded, controlled study

Anna M. BOMBARDIERI 1, 2 , Daniel B. MAALOUF 2, Richard L. KAHN 2, Yan MA 3, James J. BAE 2, Barbara WUKOVITS 2, Andrew LEE 2, Kethy M. JULES-ELYSEE 2, A. Raffaele DE GAUDIO 4, Gregory A. LIGUORI 2

1 Department of Anesthesiology, Hospital for Special Surgery, New York, NY, USA; 2 Department of Anesthesiology, Pasteur Hospital, University of Nice, Nice, France; 3 Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington D.C., USA; 4 Department of Anesthesiology and Critical Care, Universitá degli Studi di Firenze, Florence, Italy


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BACKGROUND: Continuous popliteal nerve block is utilized for postoperative analgesia after foot and ankle surgery. Whether only the total dose of local anesthetic or the combination of concentration and volume determine the characteristics of a continuous popliteal nerve infusion remains currently unknown. We hypothesized a reduction of the incidence of insensate extremity in patients given ropivacaine 0.4% at 4 mL/h compared to patients given ropivacaine 0.2% at 8mL/h.
METHODS: Sixty-four patients scheduled for major foot and ankle surgery requiring a continuous popliteal catheter infusion for postoperative analgesia were studied. Thirty-three patients were randomized to receive a continuous popliteal nerve block with 0.2% (basal 8 mL/h) and thirty-one with 0.4% (basal 4 mL/h) ropivacaine, reaching the same total dose (16 mg/h). The primary outcome was the incidence of persistent sensory block in the distal sciatic nerve distributions in the postoperative period. Secondary outcomes were the incidence of motor block, NRS pain scores at rest in the postoperative period up to 48 hours after surgery, opioid use and related side effects, patients’ satisfaction.
RESULTS: The incidence of persistent sensory block was similar in patients given 0.2% and in patients receiving 0.4% ropivacaine. The incidence of motor block, postoperative pain scores at rest, use of oral opioids, side effects and patients’ satisfaction with the quality of recovery were also similar in both groups.
CONCLUSIONS: Our results suggest that local anesthetic total dose is the primary determinant of continuous popliteal perineural infusion effects.


KEY WORDS: Pain, postoperative - Nerve block - Catheter - Orthopedics

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Publication History

Article first published online: April 10, 2018
Manuscript accepted: April 4, 2018
Manuscript revised: March 26, 2018
Manuscript received: June 28, 2017

Per citare questo articolo

Bombardieri AM, Maalouf DB, Kahn RL, Ma Y, Bae JJ, Wukovits B et al. A comparison of two different concentrations and infusion rates of ropivacaine in perineural infusion administered at the same total dose for analgesia after foot and ankle surgery: a randomized, double blinded, controlled study. Minerva Anestesiol 2018 April 10. DOI: 10.23736/S0375-9393.18.12266-8

Corresponding author e-mail

bombardieri.am@gmail.com