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Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation.

Publication ,  Journal Article
Hutto, EDG; Rice, AN; Hopkins, TJ; Muckler, VC
Published in: AANA journal
August 2020

Anesthetic modalities to mitigate the development of phantom limb pain have not been standardized into an evidence-based, multimodal anesthesia protocol to promote improved patient outcomes. This quality improvement project involved the implementation of a lower extremity, amputation-specific anesthesia protocol. In the postimplementation group, 94 patients were anesthetized for their amputation using an Amputation Improved Recovery Enhanced Recovery After Surgery (ERAS) protocol. Patient outcomes before and after protocol implementation were compared. The rate of continuous peripheral nerve block placement was higher in the postimplementation group (37.2%) than the preimplementation group (29.6%, P = .337). The 2 groups did not differ on average pain scores and morphine equivalent consumption rates per patient during hospitalization. The postimplementation group had significantly lower mean pain scores during the first 24 hours after amputation (P = .046); fewer postoperative complications (P = .001), amputation revisions (P = .003), 30-day hospital readmissions (P = .049), and readmissions related to amputation surgery (P = .019); and higher rates of early phantom limb pain that resolved during hospitalization (P = .012). Use of a standardized anesthetic protocol designed for patients undergoing amputation improved patient outcomes. Trials of this protocol elsewhere may contribute to improved recovery for patients undergoing amputations.

Duke Scholars

Published In

AANA journal

EISSN

2162-5239

ISSN

0094-6354

Publication Date

August 2020

Volume

88

Issue

4

Start / End Page

325 / 332

Related Subject Headings

  • Quality Improvement
  • Postoperative Complications
  • Phantom Limb
  • Perioperative Period
  • Nurse Anesthetists
  • Middle Aged
  • Male
  • Lower Extremity
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hutto, E. D. G., Rice, A. N., Hopkins, T. J., & Muckler, V. C. (2020). Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation. AANA Journal, 88(4), 325–332.
Hutto, Emelia D. G., Andi N. Rice, Thomas J. Hopkins, and Virginia C. Muckler. “Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation.AANA Journal 88, no. 4 (August 2020): 325–32.
Hutto EDG, Rice AN, Hopkins TJ, Muckler VC. Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation. AANA journal. 2020 Aug;88(4):325–32.
Hutto, Emelia D. G., et al. “Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation.AANA Journal, vol. 88, no. 4, Aug. 2020, pp. 325–32.
Hutto EDG, Rice AN, Hopkins TJ, Muckler VC. Perioperative Anesthetic Techniques to Reduce Surgical Morbidity After Amputation. AANA journal. 2020 Aug;88(4):325–332.

Published In

AANA journal

EISSN

2162-5239

ISSN

0094-6354

Publication Date

August 2020

Volume

88

Issue

4

Start / End Page

325 / 332

Related Subject Headings

  • Quality Improvement
  • Postoperative Complications
  • Phantom Limb
  • Perioperative Period
  • Nurse Anesthetists
  • Middle Aged
  • Male
  • Lower Extremity
  • Humans
  • Female