Utility of Peripheral Nerve Block in Lower Extremity Amputation

Area of Science:

• Anesthesiology
• Surgical Outcomes
• Pain Management

Background:

• Lower extremity amputation (LEA) affects nearly two million Americans annually.
• Phantom limb pain (PLP) is a common complication, leading to significant healthcare costs.
• Optimal anesthetic techniques for LEA and PLP prevention remain under investigation.

Purpose of the Study:

• To evaluate the effectiveness of peripheral nerve block (PNB) as a primary anesthetic modality for LEA.
• To compare perioperative outcomes, including PLP incidence, between PNB and general anesthesia (GA).

Main Methods:

• Retrospective review of 179 adult patients undergoing first-time LEA.
• Stratification by anesthetic technique: GA, PNB, neuraxial, or GA combined with PNB.
• Analysis of PLP incidence, hospital stay, opioid use, and operative time.

Main Results:

• PNB use was associated with reduced opioid requirements and operative time.
• No statistically significant difference in PLP incidence between GA and GA+PNB groups.
• Zero PLP cases observed in the small PNB-alone group.

Conclusions:

• PNB demonstrates potential benefits for LEA, including decreased opioid consumption and shorter operative durations.
• PNB shows promising results for PLP prevention, meriting further investigation.
• Prospective randomized trials are recommended to confirm PNB's efficacy as a primary anesthetic for LEA.