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Comparison of the analgesic effect of an adductor canal block using a new suture-method catheter vs. standard perineural catheter vs. single-injection: a randomised, blinded, controlled study

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@article{1a047e0680d843b58b15dcd904c9d356,
title = "Comparison of the analgesic effect of an adductor canal block using a new suture-method catheter vs. standard perineural catheter vs. single-injection: a randomised, blinded, controlled study",
abstract = "We performed a randomised, blinded, controlled study with adult patients scheduled for primary total knee arthroplasty under spinal anaesthesia. The aim was to investigate the analgesic effects of adductor canal block using catheter-based repeated boluses, either through a new suture-method catheter or a standard perineural catheter, compared with a single-injection technique. All patients received an adductor canal block after surgery with an initial bolus of 20 ml ropivacaine 0.75{\%}, followed by 20 ml of ropivacaine 0.2{\%} every 8 h in the standard and suture-method catheter groups, and sham boluses for the single-injection group. The primary outcome measure was total opioid consumption (intravenous morphine equivalents) from the end of surgery until 12:00 on postoperative day 2. Secondary outcomes were pain, muscle strength and ambulation. We randomly assigned (1:1:1) and analysed 153 patients. Total opioid consumption was median (IQR [range]) 24 (11-37 [0-148]) mg in the suture-method group, 38 (17-51 [0-123]) mg in the standard catheter group and 37 (14-57 [0-158]) mg in the single-injection group (p = 0.049). Differences were not statistically significant after Bonferroni correction (α = 0.05/3). There were no differences between groups on postoperative day 1. On postoperative day 2, there were no differences between catheter groups, but muscle strength and ambulation were improved compared with the single-injection group. We conclude that providing repeated boluses via a catheter did not decrease opioid consumption or pain compared with a single injection, but improved muscle strength and ambulation on postoperative day 2. The two types of catheters were similar.",
keywords = "Aged, Analgesia/methods, Anesthetics, Local/administration & dosage, Arthroplasty, Replacement, Knee, Catheters, Female, Humans, Injections, Male, Nerve Block/instrumentation, Pain, Postoperative/drug therapy, Ropivacaine/administration & dosage, Single-Blind Method, Sutures, Treatment Outcome, regional anaesthesia, saphenous nerve block, total knee replacement, femoral nerve block",
author = "Lyngeraa, {T S} and P Jaeger and B Gottschau and B Graungaard and Rossen-J{\o}rgensen, {A M} and I Toftegaard and U Grevstad",
note = "{\circledC} 2019 Association of Anaesthetists.",
year = "2019",
month = "11",
doi = "10.1111/anae.14814",
language = "English",
volume = "74",
pages = "1397--1405",
journal = "Anaesthesia",
issn = "0003-2409",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "11",

}

RIS

TY - JOUR

T1 - Comparison of the analgesic effect of an adductor canal block using a new suture-method catheter vs. standard perineural catheter vs. single-injection

T2 - a randomised, blinded, controlled study

AU - Lyngeraa, T S

AU - Jaeger, P

AU - Gottschau, B

AU - Graungaard, B

AU - Rossen-Jørgensen, A M

AU - Toftegaard, I

AU - Grevstad, U

N1 - © 2019 Association of Anaesthetists.

PY - 2019/11

Y1 - 2019/11

N2 - We performed a randomised, blinded, controlled study with adult patients scheduled for primary total knee arthroplasty under spinal anaesthesia. The aim was to investigate the analgesic effects of adductor canal block using catheter-based repeated boluses, either through a new suture-method catheter or a standard perineural catheter, compared with a single-injection technique. All patients received an adductor canal block after surgery with an initial bolus of 20 ml ropivacaine 0.75%, followed by 20 ml of ropivacaine 0.2% every 8 h in the standard and suture-method catheter groups, and sham boluses for the single-injection group. The primary outcome measure was total opioid consumption (intravenous morphine equivalents) from the end of surgery until 12:00 on postoperative day 2. Secondary outcomes were pain, muscle strength and ambulation. We randomly assigned (1:1:1) and analysed 153 patients. Total opioid consumption was median (IQR [range]) 24 (11-37 [0-148]) mg in the suture-method group, 38 (17-51 [0-123]) mg in the standard catheter group and 37 (14-57 [0-158]) mg in the single-injection group (p = 0.049). Differences were not statistically significant after Bonferroni correction (α = 0.05/3). There were no differences between groups on postoperative day 1. On postoperative day 2, there were no differences between catheter groups, but muscle strength and ambulation were improved compared with the single-injection group. We conclude that providing repeated boluses via a catheter did not decrease opioid consumption or pain compared with a single injection, but improved muscle strength and ambulation on postoperative day 2. The two types of catheters were similar.

AB - We performed a randomised, blinded, controlled study with adult patients scheduled for primary total knee arthroplasty under spinal anaesthesia. The aim was to investigate the analgesic effects of adductor canal block using catheter-based repeated boluses, either through a new suture-method catheter or a standard perineural catheter, compared with a single-injection technique. All patients received an adductor canal block after surgery with an initial bolus of 20 ml ropivacaine 0.75%, followed by 20 ml of ropivacaine 0.2% every 8 h in the standard and suture-method catheter groups, and sham boluses for the single-injection group. The primary outcome measure was total opioid consumption (intravenous morphine equivalents) from the end of surgery until 12:00 on postoperative day 2. Secondary outcomes were pain, muscle strength and ambulation. We randomly assigned (1:1:1) and analysed 153 patients. Total opioid consumption was median (IQR [range]) 24 (11-37 [0-148]) mg in the suture-method group, 38 (17-51 [0-123]) mg in the standard catheter group and 37 (14-57 [0-158]) mg in the single-injection group (p = 0.049). Differences were not statistically significant after Bonferroni correction (α = 0.05/3). There were no differences between groups on postoperative day 1. On postoperative day 2, there were no differences between catheter groups, but muscle strength and ambulation were improved compared with the single-injection group. We conclude that providing repeated boluses via a catheter did not decrease opioid consumption or pain compared with a single injection, but improved muscle strength and ambulation on postoperative day 2. The two types of catheters were similar.

KW - Aged

KW - Analgesia/methods

KW - Anesthetics, Local/administration & dosage

KW - Arthroplasty, Replacement, Knee

KW - Catheters

KW - Female

KW - Humans

KW - Injections

KW - Male

KW - Nerve Block/instrumentation

KW - Pain, Postoperative/drug therapy

KW - Ropivacaine/administration & dosage

KW - Single-Blind Method

KW - Sutures

KW - Treatment Outcome

KW - regional anaesthesia

KW - saphenous nerve block

KW - total knee replacement

KW - femoral nerve block

UR - http://www.scopus.com/inward/record.url?scp=85071308369&partnerID=8YFLogxK

U2 - 10.1111/anae.14814

DO - 10.1111/anae.14814

M3 - Journal article

VL - 74

SP - 1397

EP - 1405

JO - Anaesthesia

JF - Anaesthesia

SN - 0003-2409

IS - 11

ER -

ID: 58240244