The PReliMinAry (pain relief in major amputation) survey.

Shelmerdine, Lauren, Gwilym, Brenig Llwyd, Ambler, Graeme Keith, Bosanquet, David Charles ORCID: https://orcid.org/0000-0003-2304-0489 and Nandhra, Sandip 2022. The PReliMinAry (pain relief in major amputation) survey. Annals of Vascular Surgery 79 , pp. 216-218. 10.1016/j.avsg.2021.07.021

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Abstract

OBJECTIVES Major Lower Limb Amputation (MLLA) is associated with significant peri- and post-operative pain and has been identified as a research priority by patient and healthcare groups. The PReliMinAry survey was designed to evaluate existing MLLA analgesia strategies; identifying areas of equipoise and informing future research. METHODS A targeted multi-national, multi-disciplinary survey was conducted via SurveyMonkey® (October 5, 2020−November 3, 2020) and advertised via social media and society email lists. The 10-questions explored ‘pain-team’ services, pre-operative neuroleptic medication, pre-incision peripheral nerve blocks and catheters, surgically placed nerve catheters, post-operative adjunctive regimens, future research engagement and equipoise. RESULTS Seventy-six responses were received from 60 hospitals worldwide. Twelve hospitals(20%) had a dedicated MLLA pain team, 7(12%) had none. Most pain teams (n = 52; 87%) assessed pain with a 0−10 numerical rating scale. Over half of respondents “never” preloaded patients with oral neuroleptic agents(n= 42/76; 55%). Forty-seven hospitals(78%) utilized patient controlled opioid analgesia. Most hospitals are able to provide pre-incision loco-regional peripheral nerve blocks, nerve catheters and surgical nerve catheters (95%, 77%, and 90% respectively), but use was variable. Ultrasound(US) guided peripheral nerve catheters were “infrequently” or “never” used in 57% of hospitals, whilst 23% “infrequently” or “never” utilize surgically placed nerve catheters. CONCLUSIONS The survey revealed a preference towards ‘single-shot’ nerve blocks and surgical catheters. A difference between the use of US guided nerve catheters and those surgically placed likely reflects the difference of literature evaluating these techniques. Most respondents felt there was equipoise surrounding future trials evaluating nerve blocks/catheters, but less so for surgical catheters.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	0890-5096
Date of Acceptance:	17 July 2021
Last Modified:	25 Jun 2024 14:00
URI:	https://orca.cardiff.ac.uk/id/eprint/170021

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