{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:29:28Z","timestamp":1784708968619,"version":"3.55.0"},"reference-count":104,"publisher":"Oxford University Press (OUP)","issue":"3","funder":[{"name":"the Department of Defense, Congressionally Directed Medical Research Programs","award":["PT1100575"],"award-info":[{"award-number":["PT1100575"]}]},{"name":"the Department of Defense, Congressionally Directed Medical Research Programs","award":["W81XWH-15-2-0046"],"award-info":[{"award-number":["W81XWH-15-2-0046"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Objective. To review acute pain management strategies in patients undergoing amputation with consideration of preoperative patient factors, pharmacologic\/interventional modalities, and multidisciplinary care models to alleviate suffering in the immediate post-amputation setting.<\/jats:p>\n                  <jats:p>Background. Regardless of surgical indication, patients undergoing amputation suffer from significant residual limb pain and phantom limb pain in the acute postoperative phase. Most studies have primarily focused on strategies to prevent persistent pain with inclusion of immediate postoperative outcomes as secondary measures. Pharmacologic agents, including gabapentin, ketamine, and calcitonin, and interventional modalities such as neuraxial and perineural catheters, have been examined in the perioperative period.<\/jats:p>\n                  <jats:p>Design. Focused Literature Review<\/jats:p>\n                  <jats:p>Results. Pharmacologic agents (gabapentin, ketamine, calcitonin) have not shown consistent efficacy. Neuraxial analgesia has demonstrated both an opioid sparing and analgesic benefit while results have been mixed regarding perineural catheters in the immediate post-amputation setting. However, several early studies of perineural catheters employed sub-optimal techniques (distal surgical placement), and prolonged use of perineural catheters may provide a sustained benefit. Regardless of analgesic technique, a multidisciplinary approach is necessary for optimal care.<\/jats:p>\n                  <jats:p>Conclusion. Patient-tailored analgesic regimens utilizing catheter-based techniques are essential in the acute post-amputation phase and should be implemented in all patients undergoing amputation. Future research should focus on improved measurement of acute pain and comparisons of effective analgesic regimens instead of single techniques.<\/jats:p>","DOI":"10.1093\/pm\/pnw110","type":"journal-article","created":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T01:05:21Z","timestamp":1468285521000},"page":"504-519","source":"Crossref","is-referenced-by-count":12,"title":["Perioperative Pain Management Strategies for Amputation: A Topical Review"],"prefix":"10.1093","volume":"18","author":[{"given":"Michael L.","family":"Kent","sequence":"first","affiliation":[{"name":"*Department of Anesthesiology, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Lun John","family":"Hsia","sequence":"additional","affiliation":[{"name":"\u2020Department of Anesthesiology, Duke University Medical Center, Durham VA Medical Center, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Van de Ven","sequence":"additional","affiliation":[{"name":"\u2020Department of Anesthesiology, Duke University Medical Center, Durham VA Medical Center, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Buchheit","sequence":"additional","affiliation":[{"name":"\u2020Department of Anesthesiology, Duke University Medical Center, Durham VA Medical Center, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,7,7]]},"reference":[{"issue":"139","key":"2025102706413016400_pnw110-B1","first-page":"1","article-title":"Ambulatory and inpatient procedures in the United States, 1996","volume":"13","author":"Owings","year":"1998","journal-title":"Vital Health 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