The effect of intra-neural local anaesthetic infusion on pain following major lower limb amputation

Scottish Medical Journal
A J Grant, C Wood

Abstract

Critical lower limb ischaemia has an annual incidence of 500-1000 per million and around a quarter will undergo a major lower limb amputation. Post operative pain and phantom pain are recognised complications. The aim of this study was to assess the role of postoperative intraneural infusion of local anaesthetic in patients under-going major lower limb amputation. Between May 1998 and July 2001, following amputation patients either had standard post-operative analgesia or had an intra-neural infusion of 0.5% bupivicaine via an infant feeding catheter connected to a standard syringe pump (Alaris). This was a retrospective review and clinical notes of these patients were analysed to assess their post operative course, analgesic requirements and to ascertain phantom limb pain/sensation rates. All the data collected was from standard drug charts, case note entries and out-patient letters. During this time period 64 patients had a major lower limb amputation (31 patients treated routinely and 33 patients had an intra-neural anaesthetic (INA) catheter placed). In the INA group median post-operative opioid analgesia requirement was 10mg versus 74 mg (p=0.0002, Mann-Whitney U) and post-operative prescription of amitriptyline for phanto...Continue Reading

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Citations

Aug 21, 2014·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·O G S AylingG Roche-Nagle
Mar 11, 2015·Pain Practice : the Official Journal of World Institute of Pain·Ravi D ShahSanthanam Suresh
Jun 13, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·D C BosanquetC P Twine
Nov 11, 2017·British Journal of Pain·Devjit Srivastava
Nov 2, 2016·The Cochrane Database of Systematic Reviews·Maria Jenelyn M AlviarMonalisa Dungca
Aug 28, 2013·Anaesthesia and Intensive Care·R N KaddoumD L Anghelescu
May 23, 2019·British Journal of Nursing : BJN·Liz ColquhounMichael Neil
Jan 26, 2021·Pain Reports·Joachim ErlenweinFrank Petzke
May 25, 2021·Archives of Plastic Surgery·Ronald N BogdasarianEdward S Lee
Jun 6, 2021·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Ryan LalooDavid C Bosanquet
Sep 12, 2008·Current Opinion in Anaesthesiology
May 7, 2009·Current Opinion in Anaesthesiology

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