Continuous i.v. infusion of remifentanil and intraosseous lidocaine provide better analgesia than intraosseous lidocaine alone in percutaneous vertebroplasty of osteoporotic fractures

Editor—Several methods have been reported for providing anaesthesia for percutaneous vertebroplasty (PV). These include local anaesthesia alone, 1 local anaesthesia and sedation, 2 3 and general anaesthesia. 4 Sesay and colleagues 5 reported that intraosseous lidocaine provides effective analgesia in 84% of patients undergoing PV and the addition of i.v. boluses of propofol was required in about 10% of patients. Target-controlled infusions (TCI) of remifentanil in conscious sedation regimes is reported in other settings, 6 but conscious sedation with remifentanil infusion during the PV with local anaesthesia has not been evaluated. Our objectives were to evaluate the safety and efficacy of analgesia with intraosseous lidocaine associated with TCI remifentanil i.v. (ILR), compared with intraosseous lidocaine (IL) alone during PV for osteoporotic fractures.