Using Stimulating Catheters for Continuous Sciatic Nerve Block Shortens Onset Time of Surgical Block and Minimizes Postoperative Consumption of Pain Medication After Halux Valgus Repair as Compared with Conventional Nonstimulating Catheters

Casati, Andrea; Fanelli, Guido; Koscielniak-Nielsen, Zbigniew J.; Cappelleri, Gianluca; Aldegheri, Giorgio; Danelli, G.; Fuzier, Régis; Singelyn, François

doi:10.1213/01.ane.0000167232.10305.cd

Cited by 67 publications

(37 citation statements)

References 16 publications

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“…These difficulties are even more prominent when targeting the paravertebral space, as closely situated bony structures reduce sonographic demonstration of the narrow, wedge shaped paravertebral space. Using a classical blind insertion technique, the final position of 'stiff' catheter tips are not predictable and are suboptimal in 10-40% of cases [27][28][29][30]. In this study, none of the 60 introduced soft coiled catheters perforated the pleura or were misplaced into the epidural or prevertebral space.…”

Section: Discussionmentioning

confidence: 65%

Placement of coiled catheters into the paravertebral space*

et al. 2012

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SummaryThere are conflicting results with regard to the use of catheter-based techniques for continuous paravertebral block. Local anaesthetic spread within the paravertebral space is limited and the clinical effect is often variable. Discrepancies between needle tip position and final catheter position can also be problematic. The aim of this proof-of-concept study was to assess the reliability of placing a newly developed coiled catheter in human cadavers. Sixty Tuohy needles and coiled catheters were placed under ultrasound guidance, three on each side of the thoracic vertebral column in 10 human cadavers. Computed tomography was used to assess needle tip and catheter tip locations. No catheter was misplaced into the epidural, pleural or prevertebral spaces. The mean (SD) distance between catheter tips and needle tips was 8.2 (4.9) mm. The median (IQR [range]) caudo-cephalad spread of contrast dye injectate through a subset of 20 catheters was 4 (4-5[3-8]) thoracic segments. All catheters were removed without incident. Precise paravertebral catheter placement can be achieved using ultrasound-guided placement of a coiled catheter.

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Section: Discussionmentioning

confidence: 65%

Placement of coiled catheters into the paravertebral space*

et al. 2012

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“…Although these compartments communicate with each other by connections, the spread of LA is still hampered [24]. Casati et al [25] recently reported a shorter onset time of sensory and motor blocks and less LA consumption and need for rescue pain medication for sciatic nerve block with stimulating catheters compared with blind catheter advancement. These data are in agreement with our findings in brachial plexus block.…”

Section: Discussionmentioning

confidence: 99%

“…In the CC 1 group, this interval corresponds to the single-shot technique via a stimulation needle and thus is shorter. Casati et al [25] reported block procedure times of 7 ± 2 minutes with stimulating catheters for posterior popliteal sciatic nerve block. In this study, higher thresholds (≤1 mA at 0.15 ms) were used to accept electrical correctness and the time interval of measurement for catheter placement was not defined [25].…”

Section: Discussionmentioning

confidence: 99%

“…Casati et al [25] reported block procedure times of 7 ± 2 minutes with stimulating catheters for posterior popliteal sciatic nerve block. In this study, higher thresholds (≤1 mA at 0.15 ms) were used to accept electrical correctness and the time interval of measurement for catheter placement was not defined [25]. Morin et al [15] reported no significant difference in catheter placement times between stimulating (5 min) and nonstimulating catheters (4 min) for femoral nerve blocks.…”

Section: Discussionmentioning

confidence: 99%

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The effect of stimulating versus nonstimulating catheters for continuous interscalene plexus blocks in short-term pain management

Birnbaum

Kip

Spies

et al. 2007

Journal of Clinical Anesthesia

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“…Patients also received regular doses of propacetamol or ketorolac. in 98 subjects, after bolusing the popliteal catheters with 25 mL of mepivacaine 1.5% and infusing them with ropivacaine 0.2% (3 mL·hr -1 with 5 mL each 20 min prn to a maximum of two hourly doses), Casati et al 28 observed that stimulating catheters (mean stimulation threshold of the catheter = 0.39 ± 0.17 mA; pulse width = 0.15 msec) were associated with a shorter onset of sensory (15 vs 20 min for tibial nerve; 10 vs 15 min for common peroneal nerve; both P ≤ 0.02) and motor blockade (20 vs 30 min; P = 0.004), as well as a decrease in ropivacaine consumption (239 vs 322 mL; P = 0.002) and need for rescue opioid (tramadol) analgesia (25 vs 58% of patients; P = 0.002). However, during the study period (48 hr), this did not translate into a difference in the evolution sensory and motor blockade, the static and dynamic pain scores, or the incidence of side effects.…”

Section: Sciatic Block (Sb)mentioning

confidence: 99%

Ultrasonography and stimulating perineural catheters for nerve blocks: a review of the evidence

Tran

Muñoz

Russo

et al. 2008

Can J Anesth/J Can Anesth

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Purpose: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) offering blinded assessment and sample size justification, in order to determine the benefits associated with adjunctive ultrasonography (US) and stimulating perineural catheters for nerve blocks. Source:The literature search for this review was conducted during the second week of December 2007 using the MEDLINE (January 1950 to November 2007 and EMBASE (January 1980 to November 2007) databases. For US-guided peripheral and neuraxial blocks, the following medical subject heading (MeSH) terms were searched: "nerve block", "epidural anesthesia", "epidural analgesia", "epidural injection", "epidural space", "spinal anesthesia", and "spinal injection", the results were combined with "ultrasonography" (MeSH term) and "ultrasound" (key word). For stimulating perineural catheters, the following MeSH terms were cross referenced with the MeSH term, "nerve block": "peripheral catheterization", "indwelling catheterization", "catheterization", and keywords, "nerve catheter" and "continuous". Subsequently, the result of this search was combined to "stimulating" (key word). Fifteen RCTs, offering blinded assessment and sample size justification, were retained for analysis.Principal findings: For axillary blocks, US guidance yields a higher success rate than a double-injection, transarterial and a triple-injection, neurostimulation-guided technique. Compared to a quadruple-stimulation technique, no major differences can be found. The addition of nerve stimulation to US guidance offers no clear benefits for axillary blocks. For femoral blocks, compared to neurostimulation, echoguidance is associated with a local anesthetic (LA) sparing effect (up to 42%). In children, US guidance yields a LA sparing effect and a longer duration of action for lower extremity nerve blocks.Compared to their blind counterparts, stimulating catheters seem to offer limited clinical benefits. Despite providing a sparing effect on LA and opioid consumption, stimulating catheters are not associated with a decrease in side effects or analgesiarelated expenditures. Conclusions Sources : La recherche de littérature pour cet article de synthèse a été menée la deuxième semaine de décembre 2007 dans les bases de données MEDLINE (janvier 1950 à novembre 2007) et EMBASE (janvier 1980 à novembre 2007). Pour les blocs périphériques et neuraxiaux échoguidés, les termes MeSH suivants ont été recherchés : « nerve block », « epidural anesthesia », « epidural analgesia », « epidural injection », « epidural space », « spinal anesthesia » et « spinal injection », et ont été associés à « ultrasonography »

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Using Stimulating Catheters for Continuous Sciatic Nerve Block Shortens Onset Time of Surgical Block and Minimizes Postoperative Consumption of Pain Medication After Halux Valgus Repair as Compared with Conventional Nonstimulating Catheters

Cited by 67 publications

References 16 publications

Placement of coiled catheters into the paravertebral space*

Placement of coiled catheters into the paravertebral space*

The effect of stimulating versus nonstimulating catheters for continuous interscalene plexus blocks in short-term pain management

Ultrasonography and stimulating perineural catheters for nerve blocks: a review of the evidence

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