Anesthetic Considerations for Orthopedic Amputation Surgery

Abstract Purpose of Review This review summarizes the anesthetic considerations for amputation for orthopedic indications including trauma, malignancy, infection, or congenital anomalies. Much of the literature has previously focused on amputation for vascular disease. Recent Findings Neuraxial anesthesia and peripheral nerve blocks are the most promising modalities to decrease perioperative pain, though it is unclear if they prevent long-term phantom limb pain (PLP). Treatments for PLP aim to disrupt the abnormal signaling along the peripheral and central pathways, including through medications, peripheral nerve stimulators, and surgical therapies. Summary Perioperative management of orthopedic amputation patients should involve a multidisciplinary team that focuses on improved pain management, early rehabilitation, and improved patient satisfaction. Additional research is needed to determine the optimal regional anesthesia technique and evaluate its effect on perioperative outcomes.