Key result
Neuraxial anesthesia and peripheral nerve blocks are promising modalities to decrease perioperative pain in orthopedic amputations, though their effect on long-term phantom limb pain remains unclear.
Why the study?
Much of the existing literature has focused on amputation for vascular disease rather than orthopedic indications such as trauma, malignancy, infection, or congenital anomalies.
Perioperative management of orthopedic amputation patients requires a multidisciplinary approach focusing on multimodal pain management, including regional anesthesia, to improve outcomes and manage phantom limb pain.
Regional techniques may aid acute pain after orthopedic amputation; leaves open PLP prevention and optimal methods.
Purpose of Review This review summarizes the anesthetic considerations for amputation for orthopedic indications including trauma, malignancy, infection, or congenital anomalies. Much of the literature has previously focused on amputation for vascular disease. Recent Findings Neuraxial anesthesia and peripheral nerve blocks are the most promising modalities to decrease perioperative pain, though it is unclear if they prevent long-term phantom limb pain (PLP). Treatments for PLP aim to disrupt the abnormal signaling along the peripheral and central pathways, including through medications, peripheral nerve stimulators, and surgical therapies. Summary Perioperative management of orthopedic amputation patients should involve a multidisciplinary team that focuses on improved pain management, early rehabilitation, and improved patient satisfaction. Additional research is needed to determine the optimal regional anesthesia technique and evaluate its effect on perioperative outcomes.
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Kerstin Kolodzie (2025) conducted a review in Orthopedic amputation. Regional anesthesia and multimodal pain management was evaluated. Neuraxial anesthesia and peripheral nerve blocks are promising modalities to decrease perioperative pain in orthopedic amputations, though their effect on long-term phantom limb pain remains unclear.
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