Pain control following major lower limb amputation; a cohort study

ABSTRACT NUMBER: FEGGETTER MEDAL FOR SENIOR TRAINEES (ST3+)_1

 

AUTHOR
Lauren Shelmerdine

MAIN ABSTRACT TEXT

Introduction
Over 3000 Major lower-limb amputation (MLLA) are performed in the UK every year, post-operative pain can limit recovery. Anecdotally, peri-neural catheters (PNC) have lower pain scores than morphine-based patient-controlled analgesia (PCA). This cohort study aimed to identify if PNC is superior.

Methods
A retrospective review of electronic-records for those undergoing a MLLA between 2014-2018 identified those who received a PCA and a those who received a PNC. Comparative statistics were used to assess; interval pain score (visual analogue scale) at 24 and 72 hours, ‘uncontrollable pain’, supplementary analgesia and length of hospital stay (LOS).

Results
231 PCA-patients were compared to 184 PNC-patients. There was a significant reduction in; pain scores at 24 and 72 hours, uncontrollable pain and supplementary analgesia in the PNC-patients. PNC significantly decreased LOS (28 vs 38 days in the
PCA-group).

	Mean movement pain score at 24 hours	Mean movement pain score at 72 hours
PCA-Group	4.2/10	4.8/10
PNC-Group	1.2/10	1.2/10

Conclusion
PNC offers superior pain-relief when compared to PCA. The reduction in LOS could suggest improved rehabilitation and costs. A randomised control trial is underway to is shortly due to commence to formally assess this relationship.