Peri-operative management and analgesic strategy for a patient undergoing quadruple limb amputation

Fenton-May, L., Irvine, M., Huckle, Danielle and Carter, P. 2024. Peri-operative management and analgesic strategy for a patient undergoing quadruple limb amputation. Anaesthesia Reports 12 (1) , e12296. 10.1002/anr3.12296

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Abstract

Inadequately managed amputation pain can contribute to postoperative morbidity and mortality. However, amputation pain can be challenging to manage due to its complex nature, with both central and peripheral nociceptive and neuropathic elements. Here, we present the case of a 47-year old man who developed irreversible ischaemic injuries to all four limbs following admission to intensive care with sepsis. He required quadruple amputation and we describe our approach to his peri-operative management including anaesthesia, invasive monitoring and the multi-modal approach to his peri-operative management using a combination of intravenous analgesics, bilateral brachial plexus nerve catheters and a combined spinal and epidural. The patient made a good recovery and was able to return home from a rehabilitation facility 12 months after the operation, able to undertake many tasks himself with the aid of prosthetics.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Publisher:	Wiley
ISSN:	2637-3726
Date of First Compliant Deposit:	8 September 2025
Date of Acceptance:	14 April 2024
Last Modified:	08 Sep 2025 09:13
URI:	https://orca.cardiff.ac.uk/id/eprint/180962

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