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. PATIENTS AND 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.