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Related Experiment Video

Updated: Apr 11, 2026

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Published on: March 15, 2024

Pain Management in Four-Limb Amputation: A Case Report.

Nafisseh S Warner¹, Matthew A Warner¹, Susan M Moeschler^1,2

¹Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, U.S.A.

Pain Practice : the Official Journal of World Institute of Pain

|May 27, 2015

Summary

Managing acute pain after amputation is complex. This case study details a successful multimodal approach for a four-limb amputation, achieving excellent pain control and preventing phantom limb pain.

Keywords:

acute pain epidural analgesia extremity amputation four-limb amputation ketamine peripheral nerve catheter phantom limb pain quadruple amputation residual limb pain

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Last Updated: Apr 11, 2026

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

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Published on: March 15, 2024

Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain

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Published on: March 8, 2024

Author Spotlight: Insights into Remotely Supervised Neuromodulation Procedure for Phantom Limb Pain

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Published on: March 1, 2024

Area of Science:

Anesthesiology
Pain Management
Surgical Recovery

Background:

Acute and chronic pain post-amputation present significant challenges.
Preoperative pain is a risk factor for persistent postoperative pain.
Limited evidence exists for managing pain in complex, multi-limb amputations.

Observation:

A patient with gangrene underwent a four-limb amputation due to septic shock.
A comprehensive multimodal analgesic strategy was implemented perioperatively.
This included preoperative medication, continuous epidural and peripheral nerve infusions, and oral titration.

Findings:

The patient achieved satisfactory pain control over 8 months post-surgery.
No phantom limb pain was reported postoperatively.
This represents a novel approach to managing pain in a four-limb amputation scenario.

Implications:

Multimodal analgesia can be effective in complex amputation cases.
Proactive pain management may prevent chronic pain development.
This case highlights a potential strategy for challenging amputation pain.