Abstract ID: A35

Abstract Title: Is there any need for expanding perineural space before catheter placement in continuous femoral nerve blocks

Poster Type: Either

ABSTRACT BODY

Introduction: The use of stimulating catheters improves accuracy of catheter placement in continuous femoral nerve blocks (1). We investigate in this study the interest of expanding perineural space with dextrose 5% in order to ease catheter threading (2).
Methods: After Local Ethics Committee approval and informed consent, 20 patients ASA I-II scheduled for total knee replacement were randomized into two groups. In group E, after correct electro-location of femoral nerve, 10 mL of dextrose 5% are injected through the exploring needle in order to expand perineural space before catheter placement. In group nE, no expansion was performed. In all patients an obturator block with 10 mL ropivacaine 0.75% as well as a sciatic block with 20mL ropivacaine 0.75% was done. After placement of the femoral stimulating catheter and its radiological control using contrast media, 5 mL of ropivacaine 0.2% was administered followed by 5mL/h infusion during surgery, which was conducted under general anesthesia. Patients were assessed postoperatively in the recovery room. Quality of analgesia was measured by the number of 5 mL bolus of ropivacain 0.2% administered via femoral catheter to achieve complete relieve of postoperative knee pain. Assessment also focused on electrical, radiological and technical aspects involving catheter placement. Data, expressed as mean ą SD or percentage, were cross-analyzed between two independent hospital centers. Non parametric and Chi tests were used for statistic comparison.
Results: Demographic data were similar in both groups. All patients had effective obturator and sciatic nerve blocks. The use of dextrose 5% had no influence on neurostimulation used for placement of stimulating catheters. Due to the small number of patients, ease of catheter placement did not reach statistical significance between the two groups (Table).
Discussion: According to these preliminary results, to expand or not to expand perineural space seems not to make any difference for catheter placement in continuous femoral nerve blocks. Further investigation with larger number of patients is needed.
1. Reg anesth Pain Med 2004;29:212-220.
2. Reg anesth Pain Med 2004;29:189-193.

ATTACHED FILES

A35_Dilate Tab.htm

Reg Anesth Pain Med 2004; 29(2):A35