Direct Placement of a Brachial Plexus Neural Catheter for Analgesia after Traumatic Upper Limb Amputation

ABSTRACT We report a case of traumatic upper limb injury that resulted in above elbow amputation. A multimodal approach was employed to optimize postoperative analgesia; this included continuous peripheral nerve blockade, initiated intraoperatively. Surgical access onto the axillary artery for proxi...

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Bibliographic Details
Published in:Pain medicine (Malden, Mass.) Mass.), 2009-09, Vol.10 (6), p.1132-1135
Main Authors: Granville‐Chapman, Jeremy, Tennant, Mike, Aldington, Dominic, Smith, Steven Rhodes, Nott, David Malcolm
Format: Article
Language:English
Subjects:
Acute Pain
Amputation, Traumatic - complications
Amputation, Traumatic - surgery
Analgesia - methods
Anesthesia, Conduction
Anesthetics, Local
Brachial Plexus
Catheterization
Humans
Male
Military Personnel
Nerve Block
Pain - drug therapy
Pain - etiology
Pain Management
Phantom Limb - therapy
Postoperative Pain
Trauma
Upper Extremity - injuries
Warfare
Young Adult
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Summary:ABSTRACT We report a case of traumatic upper limb injury that resulted in above elbow amputation. A multimodal approach was employed to optimize postoperative analgesia; this included continuous peripheral nerve blockade, initiated intraoperatively. Surgical access onto the axillary artery for proximal vascular control allowed placement of the nerve catheter under direct vision onto the brachial plexus. The pathophysiology of phantom pain is related to our case experience. This report highlights the complex challenge of controlling pain in combat casualties and promotes employment of multimodal analgesic strategies, including advanced regional anesthesia, in the military setting.
ISSN:1526-2375
1526-4637
DOI:10.1111/j.1526-4637.2009.00638.x