Effect of Perineural Catheters in Major Lower Limb Amputatio
Controlling pain after major lower limb amputation (MLLA) is of critical importance to patients and clinicians. The postoperative use of perineural catheters (PNCs) can reduce pain in patients having an amputation.

The aim of this systematic review and meta-analysis was to assess the effect of perineural catheters (PNCs) on post-operative pain, post-operative morphine requirement, in-hospital mortality, long-term phantom limb pain, and chronic stump pain.

A systematic review using PubMed, EMBASE via OVID, and the Cochrane library was performed according to PRISMA guidelines. Studies involving patients undergoing MLLA which reported on post-operative morphine requirement, pain scores, in-hospital mortality, phantom limb pain (PLP), and chronic stump pain were included. Ten studies reporting on 731 patients were included, with 350 patients receiving a PNC and 381 receiving standard care.

--PNC use is associated with a reduction in post-operative pain and postoperative morphine requirements, although the effect of PNC on reduced postoperative morphine requirements is lost on sensitivity analysis of randomized trials only.

--No demonstrable effect was found on in-hospital mortality, PLP, or chronic stump pain.

In particular, PNC use in amputees is associated with a significant reduction in post-operative pain scores and postoperative morphine requirements, although this latter finding is lost on sensitivity analysis of randomized trials only.

European Journal of Vascular and Endovascular Surgery
Source: https://doi.org/10.1016/j.ejvs.2021.03.008