6: Nerve Blocks With Targeted Muscle Reinnervation Reduce Acute Postoperative Opioid Use in Major Lower Extremity Amputation

摘要

Major amputations of the lower extremity, specifically through and below the knee, are morbid procedures requiring general anesthesia typically followed by high doses of postoperative opioids. Many are performed on highly comorbid, chronic wound patients with a potential for increased opioid use following surgery. Given the current opioid epidemic, perioperative narcotic-reduction strategies are paramount. Our center instituted a protocol for major amputations that includes continuous regional anesthesia, for intraoperative and postoperative pain control, and targeted muscle reinnervation (TMR) nerve transfers to mitigate long-term pain. The aim of this study was to analyze the impact of continuous regional anesthesia and TMR on early postoperative opioid requirements after major lower extremity amputation at our limb salvage center.