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Anesth Analg 2007;105:288
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000263241.17090.55

LETTER TO THE EDITOR

Combined Femoral–Sciatic Catheters for Postoperative Pain Treatment After Total Knee Replacement

A. Martïnez Navas, MD, R. Ortiz de la Tabla González, MD, and T. Vázquez Gutiérrez, MD

Department of Anesthesiology; Valme Universitary Hospital; Sevilla, Spain; amartnavas{at}yahoo.es

To the Editor:

We have the following comments regarding the recent paper by Zaric et al. (1) describing postoperative analgesia after total knee replacement. First, one advantage of two catheters (femoral and sciatic) is that a bolus of rescue analgesia may be injected through only one catheter depending on the location of postoperative pain (anterior or posterior aspect of the knee). The authors comment that patients receive a bolus of different local anesthetic depending on the visual analog pain scale, but we do not know if local anesthetic is injected through femoral, sciatic or both catheters.

Second, because the concentration of local anesthetic administered through the sciatic catheter was lower than that through the femoral catheter we conclude that patients in the posterior nerve block group experienced more pain in the distribution of sciatic nerve than in the distribution of the femoral nerve. In our experience, the posterior aspect of the knee is the most frequently identified location of pain after total knee replacement (2).

REFERENCES

  1. Zaric D, Boysen K, Christiansen Ch, Christiansen J, Stephensen S, Christensen B. A comparison of epidural analgesia with combined continuous femoral-sciatic nerve blocks after toal knee replacement. Anesth Analg 2006;102:1240–6.[Abstract/Free Full Text]
  2. Martïnez Navas A, Echevarrïa Moreno M. Continuous versus single-dose sciatic nerve block to complement a femoral block after total knee replacement surgery: a randomized clinical trial. Rev Esp Anestesiol Reanim 2006;53:214–9.[Medline]




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Lippincott, Williams & Wilkins 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 HighWire Press