A1 Refereed original research article in a scientific journal

Combination of perineural and wound infusion after above knee amputation: A randomized, controlled multicenter study




AuthorsHanna von Plato, Marko Peltoniemi, Petteri Kauhanen, Eliisa Löyttyniemi, Katri Hamunen, Vesa Kontinen, Markku Hynynen, Elina Tiippana, Päivi Silvasti, Maarit Venermo, Juho Jalkanen, Minna Laukkavirta, Harri Hakovirta, Timo Salomäki, Merja Vakkala, Pekka Romsi, Minna Hyvärinen, Nina Inkinen, Jyrki Virkkunen, Kaarin Viljakka, Terhi Aalto, Antti Korpela

PublisherWILEY

Publication year2019

JournalActa Anaesthesiologica Scandinavica

Journal acronymACTA ANAESTH SCAND

Volume63

First page 1406

Last page1412

Number of pages7

ISSN0001-5172

eISSN1399-6576

DOIhttps://doi.org/10.1111/aas.13440(external)


Abstract

Background Post-operative pain after an above-knee amputation is often severe, and in the elderly patients the adverse effects of post-operative opioids are evident. We hypothesized that continuous perineural local anesthetic infusion (CPI) combined to a wound infusion will reduce acute pain and opioid consumption compared to placebo after above knee amputation.

Methods Ninety-three patients going through an above knee amputation were recruited for this randomized, controlled trial. Two catheters were placed, one to the sciatic nerve sheath and one under the fasciae during the amputation. After two 10 mL boluses of ropivacaine 0.75% a post-operative infusion of ropivacaine 0.2% or placebo (NaCl 0.9%) at 2 mL/h was administered for 72 hours to both catheters. The primary outcome was average stump pain during the first 5 days.

Results The mean intensity of stump pain during the first five post-operative days was 1.4 (0.8) in the CPI group and 1.9 (0.9) in the placebo group on VRS, mean (SD), P = .006. The opioid consumption on first five post-operative days did not differ between the groups.

Conclusion A combination of continuous perineural and wound local anesthetic infusion seems to diminish the intensity of stump pain after above knee amputation.



Last updated on 2024-26-11 at 20:35