OP12 Does continuous peripheral nerve blocks reduce phantom limb pain post amputation?

<h3>Background and Aims</h3> Phantom limb pain (PLP) is an incapacitating condition affecting a large proportion of amputees, with limited effective therapies. Prevalence, at more than 2 years, varies widely in literature from 76 to 87%. While the use of continuous peripheral nerve block (CPNB) in the postoperative period has become standard management due to consistent evidence that it reduces pain, there is currently limited evidence for the reduction in PLP. This audit aims to establish whether the use of CPNB postoperatively in below-knee amputation (BKA) patients reduces the incidence of PLP 2 years on. <h3>Methods</h3> A retrospective observational study was conducted at St George’s Hospital, London, involving 40 BKA patients who underwent amputation surgery approximately 2 years before. Data such as phantom limb sensation, pain, stump pain and duration of CPNB were collected through patient phone interviews and medical record reviews. A survey was created based on validated questionnaires such as PainDETECT and EQ-5D-5L. <h3>Results</h3> Out of 40 eligible patients, 11 had passed away (27%). From the 29 remaining patients eligible for recruitment, 16 consented to participate. Out of them, 4 reported phantom limb sensation, with 2 describing it as PLP (12.5%). 7 patients experienced stump pain, primarily related to prosthesis issues (43%). <h3>Conclusions</h3> This audit confirms postoperative CPNB as a potential effective preventive measure for PLP. There was no control group due to a well-established CPNB pathway in our hospital, therefore rendering unethical to randomize to a no-catheter group. Further larger scale analysis is advised.