Taboada Manuel, Rodríguez Jaime, Bermudez Maria, Valiño Cristina, Ulloa Beatriz, Aneiros Francisco, Gude Francisco, Cortés Joaquín, Alvarez Julian, Atanassoff Peter G
Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Travesía da Choupana s/n. 15706 Santiago de Compostela, Spain.
Anesth Analg. 2008 Oct;107(4):1433-7. doi: 10.1213/ane.0b013e3181824164.
We designed the present, prospective, randomized, double-blind study to compare the administration of an automated intermittent bolus dose with a conventional technique of continuous infusion of local anesthetic for postoperative analgesia in continuous popliteal sciatic nerve blockade.
Forty-four patients undergoing hallux valgus repair were randomly assigned to receive either a continuous infusion of 0.125% levobupivacaine with an infusion rate of 5 mL/h (continuous infusion group, n=22) or automated bolus doses of 5 mL every hour of the same local anesthetic (automated bolus group, n=22) for 24 h. Postoperative pain scores were assessed using a verbal rating pain score. The amount of rescue tramadol medication for pain was also recorded.
In patients of the automated bolus group there was a reduction in pain scores (P<0.05) during the postoperative period, when compared to patients of the continuous infusion group. Five patients in the automated bolus group (24%) and 11 patients of the continuous group (52%) required rescue tramadol analgesia (P=0.055).
The present investigation demonstrated that local anesthetic administered by an automated bolus technique provided better postoperative pain relief than a continuous infusion technique for continuous popliteal nerve block after foot surgery.
我们设计了这项前瞻性、随机、双盲研究，以比较自动间歇性推注剂量与传统持续输注局部麻醉药技术在腘窝坐骨神经连续阻滞术后镇痛中的应用效果。
44例行拇外翻修复术的患者被随机分配，分别接受以5 mL/h的输注速率持续输注0.125%左旋布比卡因（持续输注组，n = 22）或每小时自动推注5 mL相同局部麻醉药（自动推注组，n = 22），持续24小时。使用视觉模拟疼痛评分评估术后疼痛评分。还记录了用于止痛的补救性曲马多药物用量。
与持续输注组患者相比，自动推注组患者术后期间疼痛评分降低（P < 0.05）。自动推注组有5例患者（24%）和持续输注组11例患者（52%）需要补救性曲马多镇痛（P = 0.055）。
本研究表明，对于足部手术后的腘窝神经连续阻滞，自动推注技术给予局部麻醉药比持续输注技术能提供更好的术后疼痛缓解。
