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[Anesthesia and analgesia for lower limb amputation].

B Minchev, T Zakhariev, R Belopitov

    Khirurgiia
    |May 25, 2002
    PubMed
    Summary

    Anesthesia and analgesia methods for limb amputations evolved significantly between 1986 and 2000. Epidural analgesia became the predominant method, replacing traditional opioids for post-amputation pain management.

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    Area of Science:

    • Anesthesiology
    • Vascular Surgery
    • Pain Management

    Background:

    • Limb amputations due to vascular disease necessitate effective anesthesia and analgesia.
    • Historical data on anesthetic and analgesic techniques in amputation surgery is valuable for practice improvement.

    Purpose of the Study:

    • To review anesthesia and analgesia methods used in limb amputations for vascular disease.
    • To identify trends and changes in pain management strategies over a 15-year period.

    Main Methods:

    • Retrospective analysis of 296 limb amputations performed between 1986 and 2000.
    • Categorization of anesthesia types: general, epidural, and spinal.
    • Evaluation of analgesia methods, including opioids and epidurals, within the first 48 hours post-surgery.

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    Main Results:

    • General anesthesia was most common (55%), followed by epidural (29%) and spinal (14%).
    • No significant differences in mortality were observed across anesthesia types.
    • Postoperative analgesia shifted from intramuscular and oral opioids to epidural anesthesia, increasing from 2% to 83% between 1986 and 2000.
    • Pethidine was prescribed for phantom pain in 37% of patients.

    Conclusions:

    • Substantial evolution in postoperative analgesia following amputation has occurred.
    • Epidural anesthesia is now a common practice for post-amputation pain management.
    • The role of epidurals in preventing phantom pain remains a subject of ongoing discussion.