Continuous popliteal sciatic nerve block for postoperative pain control at home: a randomized, double-blinded,...

Area of Science:

• Anesthesiology
• Pain Management
• Orthopedic Surgery

Background:

• Investigated patient-controlled regional analgesia for outpatient orthopedic surgery.
• Utilized sciatic perineural catheter and portable infusion pump.
• Focused on moderately painful lower extremity procedures.

Purpose of the Study:

• To evaluate the efficacy of ropivacaine infusion via a sciatic perineural catheter for postoperative pain management.
• To compare ropivacaine with placebo (saline) in an outpatient setting.
• To assess impact on pain scores, opioid consumption, side effects, sleep quality, and patient satisfaction.

Main Methods:

• Randomized, double-blinded, placebo-controlled study with 30 patients.
• Preoperative sciatic nerve block with perineural catheter placement.
• Postoperative discharge with oral opioids and a 3-day infusion pump delivering ropivacaine or saline.
• Blinded assessment of pain, opioid use, side effects, and sleep quality.

Main Results:

• Ropivacaine infusion significantly reduced pain scores compared to saline (P < 0.001).
• Opioid use and related side effects were significantly lower in the ropivacaine group (P < 0.001).
• Sleep disturbances were significantly reduced, and overall patient satisfaction was higher with ropivacaine.

Conclusions:

• Home-based ropivacaine infusion via a popliteal sciatic perineural catheter effectively manages pain after lower extremity orthopedic surgery.
• This method decreases pain, opioid requirements, and improves sleep and satisfaction.
• No significant catheter- or local anesthetic-related complications were observed.