Original Article

HSS Journal

, Volume 3, Issue 2, pp 173-176

Similar Analgesic Effect After Popliteal Fossa Nerve Blockade with 0.375% and 0.75% Bupivacaine

  • Jacques T. Ya DeauAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University Email author 
  • , Barbara U. WukovitsAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University
  • , Vincent R. LaSalaAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University
  • , Kethy M. Jules-ElyséeAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University
  • , Leonardo ParoliAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University
  • , Richard L. KahnAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University
  • , David S. LevineAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell UniversityFoot and Ankle Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University
  • , Jane Y. LipnitskyAffiliated withDepartment of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University

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Abstract

This study tested the hypothesis that increasing the concentration of bupivacaine from 0.375 to 0.75% would increase the duration of postoperative analgesia by 3 h. Seventy patients scheduled for hospital admission after foot or ankle surgery gave consent to enter this prospective randomized trial. Patients were randomly assigned to receive a popliteal fossa block (posterior approach) using 30 cc of either 0.375% or 0.75% bupivacaine, with epinephrine. Patients also received a neuraxial anesthetic and postoperative intravenous patient-controlled analgesia. Patient characteristics, duration of analgesia, pain scores, use of analgesic medications, and side effects of analgesic therapy were determined. Duration of analgesia was similar with both concentrations of bupivacaine (0.375% 14 ± 8 h, 0.75% 13 ± 6 h; mean ± SD). Pain scores were the same for both groups on the first postoperative day (3 of 10 at rest, 5 with therapy). Analgesic use and side effects attributable to pain management did not differ between groups. In conclusion, postoperative analgesia was not affected by the concentration of bupivacaine used for the nerve block. There was no benefit to increasing the concentration of bupivacaine above 0.375% for single-injection popliteal fossa nerve blockade when performed for postoperative analgesia.

Key words

analgesia nerve block dose–response relationship