Continuous Infusions vs Scheduled Bolus Infusions

Study Overview
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Brief Summary
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To compare continuous infusions to bolus infusions and there affect on post-surgical pain.

Detailed Description
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Regional anesthetic techniques are an integral part to many anesthetic approaches, providing both intraoperative and postoperative anesthesia and analgesia. Regional anesthesia peripheral nerve blocks have been shown to reduce postoperative pain and improve measures such as opioid requirements and readiness for discharge. By using a catheter technique for continuous peripheral nerve blocks, analgesia can be extended well into post-operative days 2 and 3, further extending these benefits. Historically these catheters have implemented a continuous dosing regimen of local anesthetic, but increasingly there is evidence of improved analgesic outcomes without adverse effects by using a scheduled bolus dosing regimen. Many institutions have implemented this new protocol for catheter dosing. The beneficial effect of scheduled bolus dosing has not been studied in all blocks and all surgical procedures.

Official Title
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A Prospective Comparison of Pain and Analgesia in Patients With Continuous Peripheral Nerve Block Catheters Using Continuous Infusion or Scheduled Bolus Infusion

Conditions
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Surgical Procedure, Unspecified, Pain, Postoperative

Intervention / Treatment
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* Drug: Ropivacaine
* Drug: Ropivacaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Enrollment will be offered to adult patients with ASA physical status I, II, or III, presenting for nerve block catheters for post-operative analgesia. - Exclusion Criteria: Exclusion criteria will include: pregnancy, incarceration, age <18, BMI >35, pre-operative opioid use >30 mg morphine equivalents per day, inability to communicate with investigators by telephone, and pre-existing neuropathy of the operative extremity.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Comparison of two groups: 1) Continuous infusion group 2) Bolus Infusion group
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Continuous Infusion<br>Local anesthetic medication (Ropivacaine 0.2%) is provided at a continuous basal rate. | Drug: Ropivacaine<br>* Patient will be given a continuous infusion of local anesthetic.<br>* Other names: Continuous infusion;|
| Active Comparator: Intermittent Bolus Infusion<br>Local anesthetic medication (Ropivacaine 0.2%) is provided in scheduled, intermittent boluses. | Drug: Ropivacaine<br>* Patient will be given a scheduled intermittent bolus of local anesthetic.<br>* Other names: Bolus Infusion;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-surgical pain | Patients will rate their pain on a 0-10 scale | 2-3 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Opioid Consumption | Pain medications consumed by patients will be collected | 2-3 days after surgery |