Original contribution Nerve stimulator versus ultrasound guidance for placement of popliteal catheters for foot and ankle surgery ☆,☆☆ Daniel Maalouf MD, MPH (Assistant Attending) a,b , Spencer S. Liu MD (Clinical Professor of Anesthesiology) a,b, ⁎ , Rana Movahedi MD (Fellow) a , Enrique Goytizolo MD (Assistant Clinical Professor of Anesthesiology) a,b , Stavros G. Memstoudis MD, PhD (Clinical Assistant Professor of Anesthesiology) a,b , Jacques T. YaDeau MD, PhD (Clinical Assistant Professor of Anesthesiology) a,b , Michael A. Gordon MD (Assistant Clinical Professor of Anesthesiology) a,b , Michael Urban MD, PhD (Clinical Associate Professor of Anesthesiology) a,b , Yan Ma PhD (Assistant Professor of Biostatistics) c , Barbara Wukovits RN, BSN (Director of Pain Services) a , Dorothy Marcello BA (Research Assistant) a , Shane Reid MS (Research Assistant) a , Amanda Cook MA (Research Assistant) a a Department of Anesthesiology, Hospital for Special Surgery, New York, NY 10021, USA b Department of Anesthesiology, Weill Cornell Medical College, New York, NY 10065, USA c Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College, New York, NY 10065 Received 27 October 2010; revised 6 June 2011; accepted 8 June 2011 Keywords: Foot and ankle surgery; Nerve stimulator; Popliteal catheter; Regional anesthesia: Continuous popliteal block; Ultrasonography Abstract Study Objective: To determine whether ultrasound guidance improves the quality of continuous popliteal block when compared with a nerve stimulator after major foot and ankle surgery. Design: Prospective, randomized, double-blinded clinical trial. Setting: Operating room, Postanesthesia Care Unit (PACU), and hospital wards of a university- affiliated hospital. Patients: 45 ASA physical status 1, 2, and 3 patients undergoing elective major foot and ankle surgery. Interventions: Placement of a popliteal sciactic nerve catheter using either nerve stimulator or ultrasound guidance. In the PACU, a continuous infusion of ropivacaine 0.2% was started at a basal rate of 4 mL/hr and adjusted in a standardized fashion to maintain visual analog scale (VAS) pain scores b 4. All patients also received intravenous (IV) patient-controlled analgesia with hydromorphone and oral opioids. ☆ No author has financial interests to disclose. ☆☆ Funding: Hospital for Special Surgery's Anesthesiology Department Research and Education Fund. ⁎ Correspondence: Spencer S. Liu, MD, Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th St., New York, NY 10021, USA. Tel.: 212 606-1206; fax: 212 517-4481. E-mail address: liusp@hss.edu (S.S. Liu). 0952-8180/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.jclinane.2011.06.008 Journal of Clinical Anesthesia (2012) 24, 44–50