{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T01:07:08Z","timestamp":1759972028739,"version":"build-2065373602"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":121,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Inadequately managed amputation pain can contribute to postoperative morbidity and mortality. However, amputation pain can be challenging to manage due to its complex nature, with both central and peripheral nociceptive and neuropathic elements. Here, we present the case of a 47\u2010year old man who developed irreversible ischaemic injuries to all four limbs following admission to intensive care with sepsis. He required quadruple amputation and we describe our approach to his peri\u2010operative management including anaesthesia, invasive monitoring and the multi\u2010modal approach to his peri\u2010operative management using a combination of intravenous analgesics, bilateral brachial plexus nerve catheters and a combined spinal and epidural. The patient made a good recovery and was able to return home from a rehabilitation facility 12\u2009months after the operation, able to undertake many tasks himself with the aid of prosthetics.<\/jats:p>","DOI":"10.1002\/anr3.12296","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T22:05:42Z","timestamp":1714601142000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Peri\u2010operative management and analgesic strategy for a patient undergoing quadruple limb amputation"],"prefix":"10.1002","volume":"12","author":[{"given":"L.","family":"Fenton\u2010May","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Cardiff &amp; Vale University Health Board  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Irvine","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Cardiff &amp; Vale University Health Board  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Huckle","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Cardiff &amp; Vale University Health Board  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Carter","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Cardiff &amp; Vale University Health Board  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2049463717736492"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12307"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mkt059"},{"key":"e_1_2_5_5_1","unstructured":"PesterJM HendrixJM VaracalloM.Brachial plexus block techniques [Updated 2023 Aug 4]. In:AboukakrS Abu\u2010GhoshA AckleyWB et\u00a0al. eds.StatPearls[Internet].Treasure Island FL:StatPearls Publishing 2023.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470213\/."},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13385"},{"key":"e_1_2_5_7_1","article-title":"Supraclavicular vs. infraclavicular brachial plexus nerve blocks: clinical, pharmacological, and anatomical considerations","volume":"11","author":"Kaye AD","year":"2021","journal-title":"Anesthesia and Pain Medicine"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.12111"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-015-0551-4"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2012.07335.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12304"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.12296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T18:48:05Z","timestamp":1759949285000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.12296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/anr3.12296"],"URL":"https:\/\/doi.org\/10.1002\/anr3.12296","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"type":"print","value":"2637-3726"},{"type":"electronic","value":"2637-3726"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2024-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12296"}}