Forskning
Udskriv Udskriv
Switch language
Bispebjerg Hospital - en del af Københavns Universitetshospital
Udgivet

Programmed, intermittent boluses versus continuous infusion to the sciatic nerve - a non-inferiority randomized, controlled trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Continuing professional development (CPD) for anesthesiologists: a systematic review protocol

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. COVID-19 versus influenza A/B supeRInfectionS in the IntenSive care unit (CRISIS): Protocol for a Danish nationwide cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Phrenic Nerve Block on Severe Post-Hepatectomy Shoulder Pain: A Randomized, Double-blind, Placebo-controlled, Pilot Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Variable oxygen administration in surgical and medical wards evaluated by 30-day mortality - an observational study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Cardiac arrhythmias in critically ill patients with coronavirus disease 2019: a retrospective population-based cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Claus Behrend Christiansen
  • Mikkel Herold Madsen
  • Christian Rothe
  • Claus Bretlau
  • Lars Hyldborg Lundstrøm
  • Kai H W Lange
Vis graf over relationer

BACKGROUND: Trials comparing programmed, intermittent boluses (PIB) and continuous infusion in catheter-based nerve blocks found no analgesic differences. However, as these trials used equal doses of local anesthetic (LA), the time of action of each bolus was not accounted for. Therefore, the dose-sparing benefits of PIB may have been overlooked. We compared the analgesic effect of boluses administered in intervals resembling the time of action of each bolus with continuous infusion. We hypothesized that PIB provided non-inferior analgesia despite consuming less LA.

METHODS: Eighty-one patients undergoing fore- and midfoot surgery receiving a catheter-based sciatic nerve block were randomized to ropivacaine 0.2% as PIB of 10 ml every 8th hour or as continuous infusion, 6 ml h-1 . All participants could also receive boluses of 10 ml every 4th hour as needed. A non-inferiority randomized controlled design was used. Primary outcome was pain (VAS, 0-100 mm) for 72 h using area under curve (AUC) calculation. We assumed a linear relationship between mean VAS and AUC-VAS and used a non-inferiority margin of VAS = 20 mm, corresponding to AUC-VAS = 1440 mm h.

RESULTS: Mean difference in AUC-VAS was -416 mm h (95% CI -1076 to 244; p = .217) between continuous infusion (mean AUC-VAS 1206 mm h) and PIB (mean AUC-VAS 1621 mm h), establishing non-inferiority. Mean total LA consumption was significantly larger for continuous infusion compared to PIB ((468 ml (95% CI 458 to 478) vs. 136 ml (95% CI 123 to 148); p < 0.0001)).

CONCLUSIONS: PIB provided non-inferior analgesia compared to continuous infusion for 72 postoperative hours despite using significantly less LA.

OriginalsprogEngelsk
TidsskriftActa Anaesthesiologica Scandinavica
Vol/bind66
Udgave nummer1
Sider (fra-til)114-124
Antal sider11
ISSN0001-5172
DOI
StatusUdgivet - jan. 2022

Bibliografisk note

© 2021 Acta Anaesthesiologica Scandinavica Foundation.

ID: 68617844