Automated Boluses and Delayed-Start Timers Prolong Perineural Local Anesthetic Infusions and Analgesia Following Ankle and Wrist Orthopedic Surgery: A Case-Control Series

Med Sci Monit. 2021 Sep 28:27:e933190. doi: 10.12659/MSM.933190.

Abstract

BACKGROUND Continuous peripheral nerve blocks can be administered as continuous infusion, patient-controlled boluses, automated boluses, or a combination of these modalities. MATERIAL AND METHODS Ten patients undergoing either ankle (5) or distal radius (5) open reduction and internal fixation received single-injection ropivacaine sciatic nerve block or infraclavicular brachial plexus block and catheter. Infusion pumps were set to begin administering additional ropivacaine 6 h following the initial block as automated boluses supplemented with patient-controlled boluses. RESULTS Patients had similar pain scores when compared to previously published controls; however, local anesthetic consumption was lower in the patients, resulting in increased infusion and analgesia duration by 1 or more days in each group. CONCLUSIONS For infraclavicular and popliteal sciatic catheters, automated boluses may provide a longer duration of analgesia than continuous infusions following painful hand and ankle surgeries, respectively.

MeSH terms

  • Adult
  • Analgesia / methods*
  • Analgesia, Patient-Controlled / methods
  • Anesthetics, Local / administration & dosage*
  • Ankle / surgery*
  • Case-Control Studies
  • Female
  • Humans
  • Infusion Pumps
  • Male
  • Middle Aged
  • Nerve Block / methods
  • Orthopedic Procedures / methods
  • Pain Management / methods
  • Pain, Postoperative / drug therapy*
  • Ropivacaine / administration & dosage*
  • Ropivacaine / therapeutic use
  • Wrist / surgery*

Substances

  • Anesthetics, Local
  • Ropivacaine