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Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
Published on: March 15, 2024
2.4K
Unique Considerations for Complete Surgical Analgesia for Below-the-Knee Amputations
He Li1, David H Cho1, Vadim Tokhner1
1Department of Anesthesiology, Harbor-University of California, Los Angeles Medical Center, Torrance, USA.
Cureus
|May 5, 2021
Summary
The posterior femoral cutaneous nerve (PFCN) may significantly innervate the lower leg in some patients. Standard femoral and sciatic nerve blocks might be insufficient for below-knee amputation analgesia in these cases.
Area of Science:
- Anesthesiology
- Neuroscience
- Surgical Pain Management
Background:
- Cadaver studies suggest the posterior femoral cutaneous nerve (PFCN) innervates the posterior lower leg.
- Clinical relevance of PFCN innervation requires investigation in surgical patients.
Observation:
- A patient undergoing below-knee amputation (BKA) with femoral and sciatic nerve blocks experienced pain at posteromedial leg incisions.
- The patient reported adequate analgesia in other lower leg areas under monitored anesthesia care (MAC).
Findings:
- This case suggests a potential significant contribution of the PFCN to sensory innervation in a subset of patients.
- Standard peripheral nerve blocks (femoral and sciatic) may not provide complete surgical analgesia for BKA in these individuals.
Implications:
- Consideration of PFCN blockade may be necessary for adequate BKA analgesia in select patients.
- Further research is warranted to identify patients benefiting from PFCN blockade during BKA procedures.
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