Local anaesthetic delivery regimens for peripheral nerve catheters: a systematic review and network meta-analysis.

Abstract:

:There are numerous possible techniques for delivering local anaesthetic through peripheral nerve catheters. These include continuous infusions, patient-controlled boluses and programmed intermittent boluses. The optimal delivery regimen of local anaesthetic is yet to be conclusively established. In this review, we identified prospective trials of delivery regimens through peripheral nerve catheters. Our primary outcome was visual analogue scale scores for pain at 48 h. Secondary outcomes were: visual analogue scores at 24 h; patient satisfaction scores; rescue opioid use; local anaesthetic consumption; and nausea and vomiting. Network meta-analysis was used to compare these outcomes. Predefined sub-group analyses were performed. Thirty-three studies enrolling 1934 participants were included. In comparison with continuous infusion, programmed intermittent boluses improved visual analogue pain scores at both 48 and 24 h, the weighted mean difference (95%CI) being -0.63 (-1.12 to -0.14), p = 0.012 and -0.48 (-0.92 to -0.03), p = 0.034, respectively. Programmed intermittent boluses also improved satisfaction scores, the weighted mean difference (95%CI) being 0.70 (0.10-1.31), p = 0.023, and reduced rescue opioid use, the weighted mean difference (95%CI) in oral morphine equivalent at 24 h being -23.84 mg (-43.90 mg to -3.77 mg), p = 0.020. Sub-group analysis revealed that these findings were mostly confined to lower limb and truncal catheter studies; there were few studies of programmed intermittent boluses for upper limb catheters. Programmed intermittent boluses may provide optimal delivery of a local anaesthetic through peripheral nerve catheters. Further research is warranted, particularly to delineate the differences between upper and lower limb catheter locations, which will help clarify the clinical relevance of these findings.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Law WZW,Sara RA,Cameron AJD,Lightfoot NJ

doi

10.1111/anae.14864

subject

Has Abstract

pub_date

2020-03-01 00:00:00

pages

395-405

issue

3

eissn

0003-2409

issn

1365-2044

journal_volume

75

pub_type

杂志文章,meta分析
  • Free radicals. Formation, function and potential relevance in anaesthesia.

    abstract::Free radical species are ubiquitous in plant and animal life. This article describes briefly the formation of certain oxygen-centred free radicals which are essential for aerobic metabolism and host defences in humans. The mechanism of cytotoxicity of excess or inappropriate free radical production is described. The p...

    journal_title:Anaesthesia

    pub_type: 杂志文章,评审

    doi:

    authors: Royston D

    更新日期:1988-04-01 00:00:00

  • Hypomagnesaemia, cardiac arrhythmias and orthotopic liver transplantation.

    abstract::Two patients who underwent orthotopic liver transplantation and developed peroperative cardiac arrhythmias are presented. In one, the arrhythmias were refractory to treatment with anti-arrhythmic drug therapy until serum magnesium levels were restored to normal. The other patient had a low pre-operative serum magnesiu...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1994.tb03472.x

    authors: Ranasinghe DN,Mallett SV

    更新日期:1994-05-01 00:00:00

  • Incidence of and risk factors for difficult ventilation via a supraglottic airway device in a population of 14,480 patients from South-East Asia.

    abstract::Difficult airway practice guidelines include the use of a supraglottic airway device as part of the armamentarium to provide and maintain ventilation and oxygenation. We retrospectively reviewed 14 480 patients aged ≥ 18 years who underwent general anaesthesia. We identified 74 (0.5%) patients whose lungs were identif...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/anae.13153

    authors: Saito T,Liu W,Chew ST,Ti LK

    更新日期:2015-09-01 00:00:00

  • Profound hypocalcaemia in a patient being anticoagulated with citrate for continuous renal replacement therapy.

    abstract::Citrate, as an anticoagulant for continuous renal replacement therapy in critically ill patients, has some potential advantages over heparin, including a prolonged dialysis filter life and reduced risk of bleeding. The key parameter involved in monitoring the adequacy and safety of citrate anticoagulation during conti...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2009.06078.x

    authors: Morgan DJ,Ho KM

    更新日期:2009-12-01 00:00:00

  • Hypotensive anaesthesia for microsurgery of the middle ear. A comparison between enflurane and halothane.

    abstract::One hundred patients undergoing microsurgery of the ear were anaesthetised using thiopentone, nitrous oxide, oxygen and either halothane or enflurane with spontaneous respiration. Blood pressure was reduced to approximately 70 mmHg by the use of hypotensive agents. The efficacy of halothane and enflurane in producing ...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1982.tb01718.x

    authors: Eltringham RJ,Young PN,Fairbairn ML,Robinson JM

    更新日期:1982-10-01 00:00:00

  • Cardiac output measurement by pulse dye densitometry in cardiac surgery.

    abstract::Summary The aim of this study was to compare the accuracy of pulse dye densitometry with that of bolus thermodilution cardiac output measurement in patients before and after elective coronary artery bypass grafting. Twenty-eight patients were studied. Agreement between mean thermodilution and pulse dye densitometry ca...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.2005.04296.x

    authors: Baulig W,Bernhard EO,Bettex D,Schmidlin D,Schmid ER

    更新日期:2005-10-01 00:00:00

  • The influence of induction technique on intubating conditions 1 min after rocuronium administration: a comparison of a propofol-ephedrine combination and propofol.

    abstract::We conducted a double blind, prospective, controlled trial comparing intubating conditions after induction with a propofol-ephedrine combination or propofol alone, followed by rocuronium. One hundred adult patients were randomly assigned to receive either propofol 2.5 mg x kg(-1) and ephedrine 15 mg in combination or ...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.0003-2409.2001.02449.x

    authors: Tan CH,Onisong MK,Chiu WK

    更新日期:2002-03-01 00:00:00

  • Protocolised thromboelastometric-guided haemostatic management in patients with traumatic brain injury: a pilot study.

    abstract::Coagulopathy in patients with traumatic brain injury is associated with an increase in morbidity and mortality. Although timely and aggressive treatment of coagulopathy is of paramount importance, excessive transfusion of blood products has been linked with poor long-term outcomes in patients with traumatic brain inju...

    journal_title:Anaesthesia

    pub_type: 杂志文章,多中心研究

    doi:10.1111/anae.14670

    authors: Gratz J,Güting H,Thorn S,Brazinova A,Görlinger K,Schäfer N,Schöchl H,Stanworth S,Maegele M

    更新日期:2019-07-01 00:00:00

  • Safety and efficacy of rescue flexible bronchoscopic intubation using the Bentson floppy-tip guidewire via a supraglottic airway in critically ill children.

    abstract::Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/anae.14008

    authors: Cross D,Nyman A,James P,Durward A

    更新日期:2017-11-01 00:00:00

  • Efficacy of sugammadex in rocuronium-induced or antibiotic-induced anaphylaxis. A case-control study.

    abstract::We report 13 cases of presumed rocuronium-induced anaphylaxis in which sugammadex was administered with the intention of reversing the immunological reaction. Of these 13 cases, eight (62%) were later confirmed to be type-1 hypersensitivity reactions to rocuronium, three (23%) were triggered by an antibiotic and two (...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/anae.13178

    authors: Platt PR,Clarke RC,Johnson GH,Sadleir PH

    更新日期:2015-11-01 00:00:00

  • A comparison of remifentanil and alfentanil in patients undergoing major abdominal surgery.

    abstract::The efficacy and safety of remifentanil and alfentanil for patients undergoing major abdominal surgery were compared. Premedicated patients received a loading dose of remifentanil (1.0 microgram.kg-1; n = 116) and a continuous infusion of 0.5 microgram.kg-1.min-1, or a loading dose of alfentanil (25 micrograms.kg-1; n...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1997.24-az0051.x

    authors: Schüttler J,Albrecht S,Breivik H,Osnes S,Prys-Roberts C,Holder K,Chauvin M,Viby-Mogensen J,Mogensen T,Gustafson I,Lof L,Noronha D,Kirkham AJ

    更新日期:1997-04-01 00:00:00

  • Respiratory tract infection and anaesthesia. Haemophilus influenzae pneumonia that developed under anaesthesia.

    abstract::A 2-year-old boy with symptoms of a minor upper respiratory tract infection developed Haemophilus influenzae pneumonia that presented as hypoxaemia under anaesthesia for minor emergency surgery. The patient required 72 hours of mechanical ventilation in an intensive care unit after the anaesthetic and thereafter made ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1990.tb14831.x

    authors: Campbell NN

    更新日期:1990-07-01 00:00:00

  • Comparative study of limited intentional normovolaemic haemodilution in patients with left main coronary artery stenosis.

    abstract::Intentional normovolaemic haemodilution is a blood saving technique which can be performed when major blood loss is expected. Severe coronary artery disease and particularly left main stenosis are considered a contraindication for intentional normovolaemic haemodilution. The effects and complications of limited intent...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.1995.tb05926.x

    authors: Herregods L,Foubert L,Moerman A,François K,Rolly G

    更新日期:1995-11-01 00:00:00

  • Paraplegia following epidural analgesia.

    abstract::A case of neurological damage associated with lumbar epidural block is presented. Muscle paralysis and sensory loss were found in the immediate postoperative period and there was partial recovery of muscle power. The possible mechanisms of nerve damage are discussed. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1975.tb00955.x

    authors: Harrison PD

    更新日期:1975-11-01 00:00:00

  • Thyroid storm as a cause of loss of consciousness following anaesthesia for emergency caesarean section.

    abstract::A previously undiagnosed thyrotoxic patient was anaesthetised for an emergency Caesarean section. The recovery period was complicated by an acute thyroid crisis resulting in loss of consciousness following an apparently normal recovery from general anaesthesia. ...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1994.tb03310.x

    authors: Pugh S,Lalwani K,Awal A

    更新日期:1994-01-01 00:00:00

  • A comparison of the clinical use of the Laryngeal Tube S and the ProSeal Laryngeal Mask Airway by first-month anaesthesia residents in anaesthetised patients.

    abstract::The Laryngeal Tube S and the LMA-ProSeal are supraglottic instruments with an improved airway seal and a drainage tube to protect against regurgitation and to facilitate passage of a gastric tube. We compared the feasibility of these two instruments in a randomised, controlled clinical trial. One hundred and sixty pat...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2007.05073.x

    authors: Klaver NS,Kuizenga K,Ballast A,Fidler V

    更新日期:2007-07-01 00:00:00

  • The loss of sevoflurane from a closed breathing system.

    abstract::When volatile anaesthetics are used in a closed breathing system it is usually assumed that inflow of anaesthetic to the system matches uptake by the patient. Early laboratory reports on the interactions between sevoflurane and soda lime cast doubt on that assumption. We have measured the loss of sevoflurane, desflura...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1997.135-az0135.x

    authors: Vagts DA,Lockwood GG

    更新日期:1997-07-01 00:00:00

  • Convulsions following axillary brachial plexus blockade with levobupivacaine.

    abstract::Neurotoxicity manifesting as convulsions is a recognised complication of the administration of local anaesthetic drugs as part of a regional anaesthetic technique. We describe a case of self-limiting convulsions following the institution of an axillary brachial plexus block with levobupivacaine. Although the occurrenc...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2002.02860.x

    authors: Pirotta D,Sprigge J

    更新日期:2002-12-01 00:00:00

  • Changes in cerebral oxygenation in children undergoing surgical repair of ventricular septal defects.

    abstract::There have been few published studies on changes in cerebral oxygenation during paediatric cardiac surgery as measured by conventional near-infrared spectroscopy. We studied changes in cerebral oxygenation in 16 children undergoing surgical repair of ventricular septal defects. Fifteen of the patients showed similar p...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1046/j.1365-2044.2003.02788_7.x

    authors: Morimoto Y,Niida Y,Hisano K,Hua Y,Kemmotsu O,Murashita T,Yasuda K

    更新日期:2003-01-01 00:00:00

  • Molecular sieves: an alternative method of carbon dioxide removal which does not generate compound A during simulated low-flow sevoflurane anaesthesia.

    abstract::Molecular sieves are used in industry to 'scrub' industrial gases. We examined, during simulated low-flow closed system anaesthesia, (1) the carbon dioxide adsorbing potential of molecular sieves and (2) the reactivity of the sieves compared to soda lime using sevoflurane as an indicator. A low-flow anaesthetic system...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1995.tb05847.x

    authors: Fee JP,Murray JM,Luney SR

    更新日期:1995-10-01 00:00:00

  • Time course of action of combinations of vecuronium and pancuronium.

    abstract::Vecuronium 0.1 mg/kg, pancuronium 0.1 mg/kg, vecuronium 0.075 mg/kg + pancuronium 0.025 mg/kg, vecuronium + pancuronium 0.05 mg/kg each and vecuronium 0.025 mg/kg + pancuronium 0.075 mg/kg were compared with respect to time taken to onset of effect, duration of clinical relaxation and intubation conditions in five gro...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1986.tb13170.x

    authors: Pandit SK,Ferres CJ,Gibson FM,Mirakhur RK

    更新日期:1986-02-01 00:00:00

  • Delirium after transcatheter aortic valve implantation via the femoral or apical route.

    abstract::We thought that delirium might be less frequent after transcatheter aortic valve implantation via the femoral artery compared with via the cardiac apex. We reviewed 210 patients who underwent transcatheter aortic valve implantation between January 2009 and October 2014. The proportion (95% CI) of patients who suffered...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/anae.13524

    authors: Sharma V,Katznelson R,Horlick E,Osten M,Styra R,Cusimano RJ,Carroll J,Djaiani G

    更新日期:2016-08-01 00:00:00

  • Intra-ocular pressure changes using the laryngeal mask airway and tracheal tube.

    abstract::Intra-ocular pressure was measured before and throughout airway establishment with either the laryngeal mask airway or tracheal tube. Similar measurements were made on removal of either airway and the amount of coughing noted in the first minute after removal. There was a significantly smaller increase in intra-ocular...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1991.tb09847.x

    authors: Holden R,Morsman CD,Butler J,Clark GS,Hughes DS,Bacon PJ

    更新日期:1991-11-01 00:00:00

  • Neutral head position for placement of internal jugular vein catheters.

    abstract::A new approach to the internal jugular vein is described which keeps the head and neck in the neutral position and uses bony and cartilaginous landmarks for guidelines. Venous puncture is made along an axial line drawn superiorly from the lateral edge of the bony depression caused by the insertion of the sternocleidom...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1994.tb03421.x

    authors: Willeford KL,Reitan JA

    更新日期:1994-03-01 00:00:00

  • Epidural analgesia and breastfeeding: a randomised controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison group.

    abstract::We compared breastfeeding initiation and duration in 1054 nulliaparae randomised to bupivacaine Control epidural, Combined Spinal Epidural or Low Dose Infusion and 351 matched non-epidural comparisons. Women were interviewed after delivery and completed a postal questionnaire at 12 months. Regression analysis determin...

    journal_title:Anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2044.2009.06136.x

    authors: Wilson MJ,MacArthur C,Cooper GM,Bick D,Moore PA,Shennan A,COMET Study Group UK.

    更新日期:2010-02-01 00:00:00

  • Pain during awake nasal intubation after topical cocaine or phenylephrine/lidocaine spray.

    abstract::Although several local anaesthetic techniques are described for nasal analgesia during awake intubation, there has been little attempt to evaluate their effectiveness. We examined pain scores associated with nasal intubation in a randomised cross-over study of 25 volunteers. Local anaesthesia consisted of topical aero...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2044.2003.03264.x

    authors: Cara DM,Norris AM,Neale LJ

    更新日期:2003-08-01 00:00:00

  • Effects of nitrous oxide on liver haemodynamics and oxygen consumption in the greyhound.

    abstract::The effects of increasing concentrations of nitrous oxide 30, 50 and 70% on the hepatic circulation and hepatic oxygen consumption were investigated in seven normocapnic greyhounds. Hepatic arterial and portal venous blood flows were measured continuously using electromagnetic flow probes, and mean arterial pressure a...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1982.tb01225.x

    authors: Thomson IA,Hughes RL,Fitch W,Campbell D

    更新日期:1982-05-01 00:00:00

  • Respiratory injury in the burned patient. The role of flexible bronchoscopy.

    abstract::The purpose of the study was to investigate the role of flexible bronchoscopy in the management of patients admitted to a busy Regional burns unit, with particular reference to possible smoke inhalation injury. The basic procedure employed was that used in routine bronchoscopy for the diagnosis of bronchial carcinoma,...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1983.tb10370.x

    authors: Clark CJ,Reid WH,Telfer AB,Campbell D

    更新日期:1983-01-01 00:00:00

  • Eating in labour. A randomised controlled trial assessing the risks and benefits.

    abstract::The aim of this study was to determine whether permitting women in labour to eat a light diet would: (i) alter their metabolic profile, (ii) influence the outcome of labour, and (iii) increase residual gastric volume and consequent risk of pulmonary aspiration. Women were randomised to receive either a light diet (eat...

    journal_title:Anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2044.1999.00750.x

    authors: Scrutton MJ,Metcalfe GA,Lowy C,Seed PT,O'Sullivan G

    更新日期:1999-04-01 00:00:00

  • Spontaneous movement after injection of propofol.

    abstract::Spontaneous movement following injection of propofol at induction was studied in 303 patients. Two hundred patients were Caucasians and 103 were Asians. In a pilot study carried out prior to the main study, 26% of the Asians moved at induction as compared with 6% of the Caucasians. The patients were studied in relatio...

    journal_title:Anaesthesia

    pub_type: 杂志文章

    doi:10.1111/j.1365-2044.1996.tb07850.x

    authors: Chan A,Nickoll E,Thornton C,Doré C,Newton DE

    更新日期:1996-07-01 00:00:00