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Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
Published on: March 15, 2024
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The PReliMinAry (Pain Relief in Major Amputation) Survey
Lauren Shelmerdine1, Brenig Llwyd Gwilym2, Graeme Keith Ambler3
1Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Annals of Vascular Surgery
|October 13, 2021
Summary
Major lower limb amputation pain management varies globally, with a preference for nerve blocks and surgical catheters. Further research is needed, particularly for ultrasound-guided techniques.
Area of Science:
- Pain Management
- Surgical Analgesia
- Anesthesiology
Background:
- Major lower limb amputation (MLLA) causes significant pain, a key research priority.
- Existing MLLA analgesia strategies require evaluation to guide future research.
Purpose of the Study:
- To evaluate current MLLA analgesia strategies.
- To identify areas of clinical equipoise for future research.
Main Methods:
- A multinational, multidisciplinary survey was conducted online.
- The survey focused on pain teams, pre-operative medications, nerve blocks, catheters, and post-operative care.
Main Results:
- Seventy-six responses from 60 hospitals were analyzed.
- While nerve blocks and catheters are widely available, their use is variable.
- Ultrasound-guided peripheral nerve catheters are infrequently used in 57% of hospitals.
Conclusions:
- A preference exists for single-shot nerve blocks and surgical catheters in MLLA pain management.
- Equipoise for future trials favors nerve blocks/catheters over surgical catheters.
- Variability in ultrasound-guided catheter use may reflect literature differences.
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