Peri‐operative pain management in major lower extremity amputation in vascular Surgery: a UK anaesthetic and vascular surgery Delphi consensus study*
Authors' conclusion
This study provides the first procedure-specific consensus, delineating agreed principles and preferred pharmacological and locoregional analgesic approaches to peri-operative pain management in patients undergoing major lower extremity amputations.
Study context
- Population
- UK consultant anaesthetists and consultant vascular surgeons; peri-operative pain management in vascular surgical patients undergoing major lower extremity amputation
- Participants
- 72 panellists
- Outcome
- Consensus on peri-operative pain management statements
Methodological detailsthree-round, online, modified Delphi, multispeciality expert panel
- Three-round
- Online
- Modified Delphi
- Multispeciality expert panel
Recommendations
As reported in the abstract
Consensus statements assessed
44
Statements reaching strong consensus agreement (incl. shared cross-speciality responsibility, mainstay role of locoregional analgesia, perineural catheters, opioid-sparing approaches, protocolised decision aids with individualisation of analgesia)
32
Statements with non-consensus (notably pre-amputation initiation of locoregional analgesia, ultrasound-guided nerve catheter placement, surgeon-delivered regional analgesia)
12
Further findings
Barriers to practices
- Resource constraints and paucity of direct evidence
Original publication
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