Continuous peripheral catheters provide prolonged analgesia, reduce opioid consumption, and enhance patient satisfaction after painful surgeries.1,2  Although these clinical benefits have been firmly established, the optimal strategy for catheter dosing regimens has not. Available options include continuous infusion, patient-controlled boluses, and pump-programmed intermittent boluses. To date, there is limited evidence to endorse one technique over another to improve clinical outcomes, and contemporary regimens sometimes include all three.3,4  Adding to the complexity, the clinical advantages of modern pump technology and the regimens that can be reliably delivered are unclear.

The randomized clinical trial by Finneran et al. in this issue of Anesthesiology elegantly addresses these important questions. The authors compared the effects of two different catheter dosing regimens on outcomes after ambulatory foot and ankle surgery. The study was powered for two primary endpoints: pain on postoperative day 1 and time until local...

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