ABSTRACT
A study of continuous postoperative regional analgesia by nerve sheath block for limb amputation is presented. The authors reviewed 65 patients with amputation at the level proximal to the wrist or ankle. 15 patients of which were managed with continuous postoperative regional analgesia (CPRA) by nerve sheath block. At the time of exposure of nerve trunk during amputation, a catheter was introduced directy into the transected nerve sheath through a seperated stab wound, then infuse 0.5% bupivacaine 5ml prior to wound closure and postoperatively at the rate of 2 ml/4~6 hours for 3~4 days. The results were as follows : 1) Effective amputation stump analgesia was obtained, significantly reducing the need for narcotic analgesics. 2) 46 (70%) patients experienced Phantom phenomena and 30 (46%) patients experienced Phantom pain, a less frequently in CPRA group. 3) Phantom pain was more commonly observed in patients with rnore severe preamputation pain. 4) There were no significant relationships between the occurence of Phantom pain and the age of amputee or the level of amputation. We concluded that continuous postoperative regional analgesia by nerve sheath block significantly reduced the narcotic requirements in patients with ampotation surgeries.