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REGIONAL ANESTHESIA

Stimulating Popliteal Catheters for Postoperative Analgesia After Hallux Valgus Repair

Jaime Rodríguez, MD, PhD, Manuel Taboada, MD, Javier Carceller, MD, Juan Lagunilla, MD, Maria Bárcena, MD, and Julián Álvarez, MD, PhD

Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain

Address correspondence and reprint requests to Jaime Rodríguez, Department of Anesthesiology, Hospital Clínico de Santiago, Trav. da Choupana, s.n. 15706, Santiago de Compostela, Spain. Address e-mail to jaimerodriguezgarcia{at}nacom.es.

Stimulating catheters have been recently introduced in clinical practice. We assessed the efficacy of stimulating and nonstimulating catheter placement for pain control and local anesthetic requirements after hallux valgus repair with continuous sciatic popliteal nerve block in this comparative, randomized, blinded-to-observer study of 48 patients. A stimulating catheter was placed in groups S-125 and S-0625. The same catheter was inserted without stimulation in group NS-125. An infusion of 0.125% levobupivacaine was given in groups S-125 and NS-125, whereas 0.0625% levobupivacaine was used in group S-0625. All patients received an infusion of the test drug at a basal rate of 3 mL/h, with the possibility of an additional bolus of 3 mL every hour. Verbal analog scale (VAS) scores for pain were assessed between 6–8 h and between 19–23 h postoperatively. Multiple attempts were required for catheter insertion in all patients in groups S-125 and S-0625. Lower median (range) VAS scores for pain (0–100 points) were found in group S-125 at 6–8 h postoperatively when compared with groups S-0625 and NS-125: 5 (0–17.5) versus 60 (15–80) and 70 (25–80), respectively (P < 0.05); and lower VAS scores for pain were also found in group S-125 at 19–23 h when compared with group NS-125: 0 (0–0) and 7.5 (0–10), respectively (P < 0.05). Fewer patients required IV opioid analgesia in group S-125 than in groups S-0625 and NS-125: 0, 5, and 7 patients, respectively (P < 0.05). We conclude that efficacy in pain control was increased with stimulating catheter placement.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999