Stimulating catheters have been introduced to reduce the incidence of secondary failure after continuous peripheral nerve blocks, but they effectiveness over traditional nonstimulating catheters is still controversial. The aim of this prospective, randomized, blinded study is to detect if stimulating catheters improve postoperative compared with conventional non-stimulating catheters.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
64
Perinervous stimulating catheter ("Stimulong", "Pajunk", Germany) will be insert in lumbar plexus through tuohy needle (18G, 100mm length). 15ml mepivacaine 1% are injected before the complete resolution of the spinal anesthesia.
Spinal anesthesia will be perform at L3-L4 or L4-L5 level. Levobupivacaine 0,5% 15mg will be injected.
Continuous infusion (Mini Rythmic Evolution, Micrel) of ropivacaine 0,2% at 3ml/h, bolus 3 ml, lockout time 15 min, 12 ml/h maximum dose through perinervous catheter until 3rd postoperative day
Istituto ortopedico Gaetano Pini
Milan, Italy
Local anesthetic consumption
Evaluation of local anesthesic consumption every 6h in first 72 postoperative hours.
Time frame: 72h
Visual Analog scale (VAS) score
Evaluation of VAS static and VAS dynamic during first 72 postoperative hours
Time frame: 72h postoperatively
Up and Go test
"up and go" test: time need to get up from a chair, walk for 3 meters, and come back to seat down on the chair
Time frame: 4th postoperative day
Opioids request
Opioids consumption will be recorded throughout 72 postoperative hours
Time frame: 72h postoperatively
Quadriceps strength
evaluate bilateral muscle strength with an isometric force dynamometer to measure the force produced during a maximum voluntary isometric contraction in a lying position by the knee flex to 90°.
Time frame: preoperative and 24h, 48h, 72h postoperatively
postoperative nausea and vomiting (PONV)
Evaluation of nausea and vomit incidence in postoperative period with scale 0 from 4
Time frame: 72h postoperatively
Needle redirections
During catheter positioning number of needle redirections necessary to found lumbar plexus are recorder.
Time frame: During catheter position
Catheter insertion time
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Ketorolac 30mg 3 times a day
Buprenorphine 0,2mg twice a day if VAS\>4
Time (minutes) needed for catheter placement
Time frame: During catheter positioning