Format

Send to

Choose Destination
J Clin Anesth. 2012 Feb;24(1):44-50. doi: 10.1016/j.jclinane.2011.06.008.

Nerve stimulator versus ultrasound guidance for placement of popliteal catheters for foot and ankle surgery.

Author information

1
Department of Anesthesiology, Hospital for Special Surgery, New York, NY 10021, USA.

Erratum in

  • J Clin Anesth. 2013 Jun;25(4):355. Memstoudis, Stavros G [corrected to Memtsoudis, Stavros G].

Abstract

STUDY OBJECTIVE:

To determine whether ultrasound guidance improves the quality of continuous popliteal block when compared with a nerve stimulator after major foot and ankle surgery.

DESIGN:

Prospective, randomized, double-blinded clinical trial.

SETTING:

Operating room, Postanesthesia Care Unit (PACU), and hospital wards of a university-affiliated hospital.

PATIENTS:

45 ASA physical status 1, 2, and 3 patients undergoing elective major foot and ankle surgery.

INTERVENTIONS:

Placement of a popliteal sciactic nerve catheter using either nerve stimulator or ultrasound guidance. In the PACU, a continuous infusion of ropivacaine 0.2% was started at a basal rate of 4 mL/hr and adjusted in a standardized fashion to maintain visual analog scale (VAS) pain scores < 4. All patients also received intravenous (IV) patient-controlled analgesia with hydromorphone and oral opioids.

MEASUREMENTS:

VAS pain scores at rest and with physical therapy, ropivacaine use, opioid use, and opioid-related side effects were recorded.

MAIN RESULTS:

Cummulative ropivacaine use was lower in patients whose catheter was placed by ultrasound than by nerve stimulator guidance (mean 50 vs 197 mL, P < 0.001). Pain scores at rest and during activity were similar between groups. Cumulative opioid consumption (mean 858 vs 809 mg oral morphine equivalents) and daily frequencies of nausea (5% to 33% vs 0 to 24%) and pruritus (0 to 21% vs 0 to 24%) were similar between groups. Length of hospital stay was similar between groups (3.5 vs 3.7 days).

CONCLUSIONS:

Ultrasound guidance was associated with less local anesthetic consumption than with the nerve stimulator; however, there was little clinical benefit, as all other outcomes were similar between groups.

PMID:
22284318
DOI:
10.1016/j.jclinane.2011.06.008
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center