Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation.

Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation. AANA J. 2020 Aug;88(4):325-332 Authors: Hutto EDG, Rice AN, Hopkins TJ, Muckler VC Abstract Anesthetic modalities to mitigate the development of phantom limb pain have not been standardized into an evidence-based, multimodal anesthesia protocol to promote improved patient outcomes. This quality improvement project involved the implementation of a lower extremity, amputation-specific anesthesia protocol. In the postimplementation group, 94 patients were anesthetized for their amputation using an Amputation Improved Recovery Enhanced Recovery After Surgery (ERAS) protocol. Patient outcomes before and after protocol implementation were compared. The rate of continuous peripheral nerve block placement was higher in the postimplementation group (37.2%) than the preimplementation group (29.6%, P = .337). The 2 groups did not differ on average pain scores and morphine equivalent consumption rates per patient during hospitalization. The postimplementation group had significantly lower mean pain scores during the first 24 hours after amputation (P = .046); fewer postoperative complications (P = .001), amputation revisions (P = .003), 30-day hospital readmissions (P = .049), and readmissions related to amputation surgery (P = .019); and higher rates of early phantom limb pain that resolved during hospitalization (P = .012). Use of a standardized anesthetic proto...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research