• Manuel Taboada, Jaime Rodríguez, Maria Bermudez, Marcos Amor, Beatriz Ulloa, Francisco Aneiros, Sergi Sebate, Joaquin Cortés, Julian Alvarez, and Peter G Atanassoff.
• University of Santiago de Compostela, and Department of Anesthesiology, Hospital Clínico Universitario de Santiago, Spain. manutabo@yahoo.es
• Anesthesiology. 2009 Jan 1;110(1):150-4.

BackgroundThis investigation was designed to compare a new methodology of automated regular bolus with a continuous infusion of local anesthetic for continuous popliteal sciatic block; both regimens were combined with patient-controlled analgesia (PCA).MethodsFifty patients undergoing hallux valgus repair were randomly allocated to receive an infusion of 0.125% levobupivacaine administered through a popliteal catheter as an automated regular bolus (n = 25) or as a continuous infusion (n = 25), both combined with PCA. Postoperative pain scores, incremental doses delivered by the PCA, local anesthetic consumed per hour, and the need for rescue tramadol analgesia were recorded.ResultsBoth dosing regimens provided similar postoperative analgesia. Consumption of local anesthetic (5.14 ml/h, 5-5.75 ml/h) and dose request from the PCA (1, 0-5.4) was lower in the automated bolus group as compared to the continuous infusion group (5.9 ml/h, 5.05-7.8 ml/h; doses by PCA: 6.5, 0-20.5; P < 0.05). The need for rescue tramadol was similar in the two groups.ConclusionIn continuous popliteal sciatic block, local anesthetic administered as an automated regular bolus in conjunction with PCA provided similar pain relief as a continuous infusion technique combined with PCA; however, the new dosing regimen reduced the need for additional PCA and the overall consumption of local anesthetic.

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