Dual Nerve Block vs Single Nerve Block
A new study has shown that better pain management for foot and ankle surgery is achieved when CRNAs or anesthesiologist chose to administer two continuous nerve blocks instead of a single popliteal block. The single block includes a continuous infusion of Naropin (ropivacaine HCL injection) via popliteal catheter with single-injection. The dual nerve block entails two continuous infusions of ropivacaine through popliteal and saphenous catheters.
60 patients took part in a study where they were undergoing major procedures of the ankle or foot. The (Single Group) contained 30 participants that received the traditional continuous infusion of Naropin (ropivacaine HCL injection) via popliteal catheter with single-injection. The (Dual Group) consisted of 30 participants who were administered two continuous infusions of ropivacaine via popliteal and saphenous catheters. Post-operative pain scores along with the incidence of nausea/vomiting where recorded and compared between the two groups.
Results of the study showed that the patients who received the dual block required considerably less narcotics and had far better pain control for days following the surgery. The incidence of post-operative nausea was also lower in the (Dual Group).
According to Orthopedicstoday:
“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.”
Patients who had the dual popliteal/saphenous nerve blocks reported much more satisfaction with their pain management. Results of this study also showed that the patient group who received the single continuous block, were 2.85 times more likely to have nausea after being discharged requiring anti-nausea medications. Being able to limit the amount of narcotic patients require has always been an effective way to reduce post operative nausea and vomiting.
During the annual meeting of the Association of American Society of Regional Anesthesia and Pain Medicine, these findings were presented, and shared with all the CRNAs and Anesthesiologists that attended.
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American Association of Nurse Anesthetist