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Peripheral Nerve Catheters
1. Peripheral Nerve Catheters; Stimulating Versus Non stimulating An Evidence Based Approach Nabil M Elkassabany MD MSCE Assistant Professor Director; Orthopedic Anesthesia Section Department of Anesthesiology and Critical Care University of Pennsylvania Health System
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4. Continuous perineural analgesia versus systemic opioids A meta-analysis published in 2006 (19 RCTs with 603 patients) compared continuous perineural analgesia versus mixed systemic opioids (13 of 19 RCTs used IV PCA) Richman JM, et al. Anesth Analg 2006;102:248â57 Perineural analgesia, which can be used on an ambulatory basis, provided statistically superior analgesia at rest and with activity for 48â72 h with a reduction in risk of nausea, sedation, pruritus but increased risk of motor block. Clinically superior analgesia was apparent at rest for the first24 h and with activity for the first 48 h. Ilfeld BM, Enneking FK. Et al: Anesth Analg 2005;100:1822â33 Summary statement: Meta-analysis indicates that continuous perineural analgesia provides clinically superior analgesia for up to 48 h after surgery with reduced side effects when compared with systemic opioids.
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6. CONCLUSIONS: SSFNB or continuous FNB (plus PCA) was found to be superior to PCA alone for postoperative analgesia for patients having total knee arthroplasty. The impact of adding a sciatic block or continuous FNB to a SSFNB needs to be studied further.
30. CONCLUSION: For popliteal-sciatic perineural catheters, ultrasound guidance takes less time and results in fewer placement failures compared with stimulating catheters. However, analgesia may be mildly improved with successfully placed stimulating catheters.