Reduced opioid use and lower pain scores found with use of dual nerve block
Patients who underwent major foot and ankle surgery experienced a reduced need for opioid analgesics, lower pain scores and higher patient satisfaction with the use of two continuous nerve blocks compared with a continuous popliteal block with a single-injection saphenous block, according to study results.
The study, results of which were presented at the Association of American Society of Regional Anesthesia and Pain Medicine Annual Meeting, included 60 patients undergoing major foot and ankle procedures assigned to receive either a continuous infusion of Naropin (ropivacaine HCL injection, Fresenius Kabi) via popliteal catheter with single-injection saphenous nerve block (single group) or two continuous infusions of ropivacaine via popliteal and saphenous catheters (dual group) for postoperative pain management. Patient diary and daily phone interviews through postoperative day 3 were used to collect data.
Results showed a significant reduction in the consumption of opioid analgesics among patients in the dual group at postoperative days 1 and 2, as well as at-rest pain scores of less than 4 for all time points and significantly less pain reported during activities. The dual group also reported significantly higher pain management patient satisfaction, according to study results. The researchers found patients in the single group were 2.85 times more likely to require medication to control nausea following discharge.
Among patients who did not receive intravenous Ofirmev (acetaminophen), significant reductions in opioid use and pain were found at postoperative days 1 and 2 in the dual group compared with patients in the single group.
Results also showed the dual group had significantly higher patient satisfaction with pain management on postoperatively days 1, 2 and 3. Similarly, among patients who did receive acetaminophen, the researchers found significant reductions in pain at rest and with activity and higher patient satisfaction at postoperative day 1 in the dual group vs. the single group. – by Casey Tingle
Kasper V, et al. Poster #402. Presented at: Association of American Society of Regional Anesthesia and Pain Medicine Annual Meeting. May 14-16, 2015; Las Vegas.
Disclosure: The researchers report no relevant financial disclosures.