A “New” Automated Bolus Technique for Continuous Popliteal Block: A Prospective, Randomized Comparison with a Continuous Infusion Technique

In Brief BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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. IMPLICATIONS: A comparison of two dosing regimens in continuous popliteal sciatic block for postoperative analgesia after foot surgery demonstrated that local anesthetic, administered via an automated bolus technique, provided better pain relief than a continuous infusion technique.