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Nerve sheath catheter analgesia after amputation
Timothy E Morey1, John Giannoni, Eddy Duncan
1Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610, USA.
Clinical Orthopaedics and Related Research
|April 16, 2002
Summary
Continuous nerve sheath catheter analgesia may reduce phantom limb pain after amputation. This technique showed a lower incidence of phantom limb pain compared to historical data, especially for oncologic amputations.
Area of Science:
- Pain Management
- Surgical Outcomes
- Anesthesiology
Background:
- Continuous infusion of local anesthetic via nerve sheath catheters offers effective post-amputation pain relief.
- The impact of this technique on phantom limb pain incidence remains debated.
Purpose of the Study:
- To investigate the influence of continuous nerve sheath catheter analgesia on phantom limb pain.
- To assess the effect of primary anesthetic technique (general vs. regional) on phantom limb pain incidence.
Main Methods:
- Retrospective study of 39 patients who underwent amputation between 1990 and 1999.
- Data collected included amputation details, anesthetic technique, and pain assessment 6 months post-surgery.
- Phantom limb pain assessed using a verbal scale (0-10); incidence defined as a score >= 3.
Main Results:
- The incidence of phantom limb pain was 67%, lower than the historic 80% incidence.
- Proximal amputations were associated with a higher incidence of phantom limb pain compared to distal amputations.
- Primary anesthetic technique did not significantly influence phantom limb pain incidence.
Conclusions:
- Continuous nerve sheath catheter infusion is associated with a reduced incidence of phantom limb pain post-amputation.
- This technique shows promise, particularly for patients with amputations due to oncologic indications.
- Further research may clarify optimal use for specific amputation levels.