• V Contreras-Dominguez, P Carbonell-Bellolioa, A Ojeda-Greciet, and E S Sanzana.
• Servicio de Anestesiología, Hospital Clinico Regional de Concepción, Chile. vcontreras@netanestesia.cl
• Rev Esp Anestesiol Reanim. 2006 Dec 1;53(10):626-32.

BackgroundThe continuous femoral nerve block is used for postoperative orthopedic analgesia.ObjectiveTo evaluate 2 concentrations of bupivacaine with clonidine in 3 methods of administration for performing a continuous femoral nerve block.Material And MethodsRandomized controlled trial in ASA 1-2 patients in 6 groups. In groups 1, 2, and 3, the combination used was 0.125% bupivacaine plus clonidine. In groups la, 2a, and 3a, the combination was 0.0625% bupivacaine plus clonidine. Methods of administration were as follows: groups 1 and la, 10 mL x h(-1) in continuous infusion; groups 2 and 2a, 5 mL h x (-1) in continuous infusion plus 2.5 mL every 30 minutes through a patient-controlled analgesia (PCA) system; groups 3 and 3a, 5 mL every 30 minutes in a PCA system. Pain on a visual analog scale (VAS) and amounts of bupivacaine and morphine used were recorded 2 and 48 hours after surgery.ResultsA total of 105 patients were enrolled: 17 in group 1, 18 in group la, 18 in group 2, 17 in group 2a, 17 in group 3, and 18 in group 3a. No significant differences between any of the 6 groups were observed for patient characteristics, postoperative VAS scores, or morphine use.ConclusionsA continuous femoral nerve block is useful for managing pain after anterior cruciate ligament surgery. The application of 5 mL x h(-1) in continuous infusion or in PCA system bolus doses provides excellent postoperative analgesia. Use of 0.0625% bupivacaine decreases overall consumption of analgesic and is not detrimental to quality of analgesia.

59 keywords...

hide…