The effectiveness of ambulatory continuous popliteal sciatic nerve blockade on patient-reported overall benefit of analgesia in patients undergoing foot or ankle surgery (CAREFREE trial); a randomized, open label, non-inferiority trial

Admiraal, M; Smulders, PSH; Rutten, MVH; de Groot, EK; Heine, Y; Baumann, HM; van der Vegt, VHC; Halm, JA; Hermanns, H; Schepers, T; Hollmann, MW; Hermanides, J; Ten Hoope, W

doi:10.1016/j.jclinane.2024.111451

Regional anesthesia

The effectiveness of ambulatory continuous popliteal sciatic nerve blockade on patient-reported overall benefit of analgesia in patients undergoing foot or ankle surgery (CAREFREE trial); a randomized, open label, non-inferiority trial

J Clin AnesthPublished 3 Apr 2024Randomised controlled trial

Primary result · OBAS over timeResultDifference −1.9 points 90% CI −3.1 to −0.7

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Authors' conclusion

Ambulatory continuous popliteal sciatic nerve blockade is non-inferior to standard of care with single shot popliteal sciatic nerve blockade on patient-reported overall benefit of analgesia.

Study context

Population: Adults (≥18 years) scheduled for elective inpatient foot or ankle surgery, tertiary hospital in the Netherlands
Participants: 22 vs 22

Comparison: Ambulatory continuous popliteal sciatic nerve blockade vs standard of care
Ambulatory continuous popliteal sciatic nerve blockaden = 22
Standard of caren = 22reference
Primary endpoint: Difference in overall benefit of analgesia score (OBAS: pain, side effects of analgesics, patient satisfaction), measured daily
Follow-up: First to third day after surgery

Methodological detailssingle-centre, open label, non-inferiority

Single-centre
Open label
Non-inferiority

Primary result

OBAS over time · first three postoperative days

Difference

−1.9 points

90% CI −3.1 to −0.7

Ambulatory continuous popliteal sciatic nerve blockade vs Standard of care

difference −1.9 points (90% CI −3.1 to −0.7)

Non-inferiority margin 2 as printed, not drawn

As reported in the abstract

Secondary outcomes

Outcome	← Lower with ambulatory continuous popliteal sciatic nerve blockade ←→ Higher with ambulatory continuous popliteal sciatic nerve blockade →	Difference (oral MME) (95% CI)
Opioid consumption over time · first five postoperative daysSignificantly fewer opioids	−20−10010	−8.7 (−16.1 to −1.4)
	−20−10010Difference, oral MME (linear scale)

Original publication

The effectiveness of ambulatory continuous popliteal sciatic nerve blockade on patient-reported overall benefit of analgesia in patients undergoing foot or ankle surgery (CAREFREE trial); a randomized, open label, non-inferiority trial. J Clin Anesth. Published 3 April 2024. doi:10.1016/j.jclinane.2024.111451

Read the original article ↗

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