Peripheral nerve catheter techniques provide pain relief on movement for upper and lower limb arthroplasty and amputation. The optimal perineural concentration and volume of ropivacaine and levobupivacaine are not known for upper or lower limb block. The most common complication associated with perineural infusion is infection and, thus, aseptic technique is necessary for both insertion of catheters and use of elastomeric balls. Compared with parenteral opioids, perineural infusion of local anaesthetic accelerates rehabilitation and reduces hospital length of stay. However, little evidence exists regarding surgical outcomes, particularly those concerned with functional wellbeing.
Graeme McLeod PGCertMedEd MD MRCGP FRCA FFPMRCA is a Consultant & Honorary Reader in Anaesthesia, University Department of Anaesthesia and Clinical Lead for Anaesthetic Research, Ninewells Hospital & Medical School, Dundee, UK. Conflicts of interest: none declared