title: The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation.
abstract: BACKGROUND
  This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics.
  
  
  METHODS
  We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively.
  
  
  RESULTS
  The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death.
  
  
  CONCLUSIONS
  Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.
authors: 1 Krankenhaus Barmherzige Brüder Regensburg, Germany.
authors: Christian
authors: C
authors: Uhl
authors: Thomas
authors: T
authors: Betz
authors: Andrea
authors: A
authors: Rupp
authors: Markus
authors: M
authors: Steinbauer
authors: Ingolf
authors: I
authors: Töpel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000671:Amputation, Surgical / Q000009:adverse effects / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D007260:Infusion Pumps; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000628:therapy; D010865:Pilot Projects; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local
keywords: Continuous wound infusion system; phantom pain; stump pain; transfemoral amputation