Peripheral Nerve Blocks for Above-the-knee Amputations

Peripheral Nerve Blocks for Upper Leg Amputations

Surgery performed with nerve blocks and sedation may be safer and provide better pain control compared to general anesthesia and opioid therapy in high-risk patient populations such as elderly and troubled with peripheral vascular disease, diabetes, hypertension, coronary artery disease, and chronic obstructive pulmonary disease (COPD).

Avoidance of general anesthesia in certain high-risk patient populations may have additional benefits beyond improved postoperative pain scores and analgesic consumption. The primary objective of this research will be to evaluate the ability of the femoral, sciatic, lateral femoral cutaneous nerve (LFCN), and obturator blocks to provide surgical anesthesia.

Inclusion Criteria:

• Patients undergoing above-the-knee amputation or knee disarticulation
• Ability to understand and provide informed consent

Exclusion Criteria:

• Patient refusal or inability to provide informed consent
• True allergy, not sensitivity, to any of the following substances:
• - Local anesthetics
• - Propofol or other sedative agents
• - General anesthetic agents
• Pregnancy
• Severe hepatic impairment
• Evidence of infection at or near the proposed needle insertion site
• Any sensorimotor deficit, whether acute or chronic, as determined by the PI
• Chronic use of opioid medication
• BMI ≥ 35