A prospective, randomized comparison between the popliteal and subgluteal approaches for continuous sciatic nerve block with stimulating catheters

Anesth Analg. 2006 Jul;103(1):244-7, table of contents. doi: 10.1213/01.ane.0000220946.64570.73.

Abstract

In this prospective, blinded study, we randomized 56 patients undergoing hallux valgus repair to receive continuous sciatic nerve block using a subgluteal (n = 28) or a posterior popliteal approach (n = 28) with a perineural stimulating catheter. Postoperatively, the stimulating catheter was connected to a patient-controlled analgesia pump with 0.0625% levobupivacaine (basal infusion rate of 3 mL/h, patient-controlled bolus dose of 3 mL, and lockout time of 20 min). Both approaches provided similar postoperative analgesia; however, local anesthetic consumption was larger in the popliteal group (4.9 +/- 1.4 mL/h) compared with the subgluteal group (3.8 +/- 1.1 mL/h; P < 0.05). We conclude continuous postoperative analgesia using stimulating catheters was effective at both injection sites; however, a subgluteal approach reduced the overall amount of local anesthetic.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Analgesia, Patient-Controlled
  • Anesthetics, Local
  • Bupivacaine / analogs & derivatives
  • Catheterization / methods*
  • Double-Blind Method
  • Electric Stimulation
  • Hallux Varus
  • Humans
  • Levobupivacaine
  • Nerve Block / methods*
  • Pain Measurement
  • Pain, Postoperative
  • Sciatic Nerve*

Substances

  • Anesthetics, Local
  • Levobupivacaine
  • Bupivacaine