Effect of continuous injection of pain relief medication around nerves after amputations of the leg

Not Applicable

Conditions: Health Condition 1: L089- Local infection of the skin and subcutaneous tissue, unspecifiedHealth Condition 2: I739- Peripheral vascular disease, unspecified

Recruitment & Eligibility

Inclusion Criteria

Adult patients (Age >= 18 years) undergoing elective or emergency major lower limb amputations

Exclusion Criteria

1.Patients undergoing hip disarticulation, and hindquarter amputation.

2.Patients who have an allergy to bupivacaine

3.Patients are expected to be requiring sedation or ventilatory support for more than 24 hours.

4.Patients undergoing revision amputation who have been previously recruited into the study.

5.Patients undergoing bilateral amputations.

6.Patients in whom the appropriate nerve could not be identified.

7.Patients undergoing Guillotine amputation.

8.Patient denying consent

Primary Outcome Measures

Name	Time	Method
To determine the decrease in patientâ??s post-operative opioid requirement in those undergoing major lower limb amputation and receiving continuous perineural infusion of bupivacaine for three days compared to those receiving standard careTimepoint: Measured every 6h for 72h

Secondary Outcome Measures

Name	Time	Method
To determine and compare the postoperative continuous perineural infusion of Bupivacaine and standard management after major lower limb amputation for incidence of catheter-related complications (brocade, slippage, wound infections). <br/ ><br>Timepoint: duration of hospital stay;To determine and compare the postoperative continuous perineural infusion of Bupivacaine and standard management after major lower limb amputation for incidence of Phantom limb painTimepoint: 3 months post op;To determine and compare the postoperative continuous perineural infusion of Bupivacaine and standard management after major lower limb amputation for postoperative mean pain score assessed using the visual analog scale (VAS) for three days in both groups. <br/ ><br>Timepoint: 3 days