Perioperative peripheral nerve blocks for elective below-knee amputations and phantom limb syndrome: an exploratory multicenter retrospective cohort study
Authors' conclusion
In this multicenter electronic health record-based cohort, exploratory analysis showed that perioperative PNB use was associated with increased rates of documented PLS coding across subgroups.
Study context
- Population
- Adults undergoing elective below-knee amputation, Epic Cosmos data 2016 to 2025
- Participants
- 38,433 adults
- Exposure
- Perioperative PNB vs no PNB
- PNBn = 7,430
- Non-blockn = 31,003reference
- Outcome
- Phantom limb syndrome diagnosis (ICD-10-CM codes G54.6, G54.7)
- Follow-up
- Within 12 months of surgery
Methodological detailsmulticentre, exploratory, electronic health record-based (Epic Cosmos)
- Multicentre
- Exploratory
- Electronic health record-based (Epic Cosmos)
Main finding
As reported in the abstract
PNB vs Non-blockMantel-Haenszel RR (95% CI)
Adjusted for age, sex, and race only
1.24(1.20–1.28)
- PNB
- absolute difference 3.7%
Observational data: associations, not effects.
Secondary outcomes
- Peripheral nerve blocks (PNBs) associated with a shorter length of stay (LOS)
Original publication
Perioperative peripheral nerve blocks for elective below-knee amputations and phantom limb syndrome: an exploratory multicenter retrospective cohort study. Reg Anesth Pain Med. Published 4 September 2026. doi:10.
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