{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T15:07:05Z","timestamp":1784992025108,"version":"3.55.0"},"reference-count":35,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012068","name":"Health and Care Research Wales","doi-asserted-by":"publisher","award":["1198"],"award-info":[{"award-number":["1198"]}],"id":[{"id":"10.13039\/100012068","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,11,9]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore patient experiences, understanding and perceptions of analgesia following major lower limb amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative interview study, conducted as part of a randomised controlled feasibility trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants were recruited from two general hospitals in South Wales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Interview participants were patients enrolled in PLACEMENT (Perineural Local Anaesthetic Catheter aftEr Major lowEr limb amputatioN Trial): a randomised controlled feasibility trial comparing the use of perineural catheter (PNC) versus standard care for postoperative pain relief following major lower limb amputation. PLACEMENT participants who completed 5-day postoperative follow-up, were able and willing to participate in a face-to-face interview, and had consented to be contacted, were eligible to take part in the qualitative study. A total of 20 interviews were conducted with 14 participants: 10 male and 4 female.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi-structured, face-to-face interviews were conducted with participants over two time points: (1) up to 1\u2009month and (2) at least 6\u2009months following amputation. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Interviews revealed unanticipated benefits of PNC usage for postoperative pain relief. Participants valued the localised and continuous nature of this mode of analgesia in comparison to opioids. Concerns about opioid dependence and side effects of pain relief medication were raised by participants in both treatment groups, with some reporting trying to limit their intake of analgesics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings suggest routine placement of a PNC following major lower limb amputation could reduce postoperative pain, particularly for patient groups at risk of postoperative delirium. This method of analgesic delivery also has the potential to reduce preoperative anxiety, alleviate the burden of pain management and minimise opioid use. Future research could further examine the comparison between patient-controlled analgesia and continuous analgesia in relation to patient anxiety and satisfaction with pain management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ISRCTN: 85710690; EudraCT: 2016-003544-37.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-054618","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T12:31:23Z","timestamp":1638361883000},"page":"e054618","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Exploring patients\u2019 experiences of analgesia after major lower limb amputation: a qualitative study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1973-8286","authenticated-orcid":false,"given":"Sarah","family":"Milosevic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Strange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme K","family":"Ambler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Bosanquet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8465-2492","authenticated-orcid":false,"given":"Cherry-Ann","family":"Waldron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Thomas-Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P","family":"Twine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Brookes-Howell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,12,1]]},"reference":[{"key":"2024112512204670000_11.12.e054618.1","doi-asserted-by":"crossref","unstructured":"Suer M , Sehgal N . Post-amputation pain. In: Suer M , Sehgal N , eds. Questions and answers in pain medicine. Cham: Springer, 2021: 143\u20137.","DOI":"10.1007\/978-3-030-68204-0_18"},{"key":"2024112512204670000_11.12.e054618.2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.neulet.2018.11.044","article-title":"Pre- and postoperative predictors of phantom limb pain","volume":"702","author":"Larbig","year":"2019","journal-title":"Neurosci Lett"},{"key":"2024112512204670000_11.12.e054618.3","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1016\/j.apmr.2018.11.024","article-title":"A prospective longitudinal study of trajectories of depressive symptoms after dysvascular amputation","volume":"100","author":"Roepke","year":"2019","journal-title":"Arch Phys Med Rehabil"},{"key":"2024112512204670000_11.12.e054618.4","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.apmr.2016.09.118","article-title":"Cross-sectional assessment of factors related to pain intensity and pain interference in lower limb prosthesis users","volume":"98","author":"Morgan","year":"2017","journal-title":"Arch Phys Med Rehabil"},{"key":"2024112512204670000_11.12.e054618.5","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2001.26074"},{"key":"2024112512204670000_11.12.e054618.6","first-page":"1","article-title":"Health-related quality of life and prosthesis use among patients amputated due to peripheral arterial disease - a one-year follow-up","author":"Torbj\u00f6rnsson","year":"2020","journal-title":"Disabil Rehabil"},{"key":"2024112512204670000_11.12.e054618.7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/bjaed\/mkv028","article-title":"Pain after amputation","volume":"16","author":"Neil","year":"2016","journal-title":"BJA Educ"},{"key":"2024112512204670000_11.12.e054618.8","unstructured":"Gough MJ , Juniper M , Freeth H . Lower limb amputation: working together. London: National Confidential Enquiry into Patient Outcome and Death, 2014."},{"key":"2024112512204670000_11.12.e054618.9","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000181289.09675.7D"},{"key":"2024112512204670000_11.12.e054618.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2017.07.002"},{"key":"2024112512204670000_11.12.e054618.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2009.05.095"},{"key":"2024112512204670000_11.12.e054618.12","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H386"},{"key":"2024112512204670000_11.12.e054618.13","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S144066"},{"key":"2024112512204670000_11.12.e054618.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2015.04.030"},{"key":"2024112512204670000_11.12.e054618.15","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ejvs.2021.03.008","article-title":"Systematic review and meta-analysis of the effect of perineural catheters in major lower limb amputations","volume":"62","author":"Laloo","year":"2021","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2024112512204670000_11.12.e054618.16","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-017-2357-x","article-title":"Perineural local anaesthetic catheter after major lower limb amputation trial (PLACEMENT): study protocol for a randomised controlled pilot study","volume":"18","author":"Bosanquet","year":"2017","journal-title":"Trials"},{"key":"2024112512204670000_11.12.e054618.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029233"},{"key":"2024112512204670000_11.12.e054618.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.12.006"},{"key":"2024112512204670000_11.12.e054618.19","doi-asserted-by":"crossref","DOI":"10.1097\/PR9.0000000000000647","article-title":"Current methods and challenges for acute pain clinical trials","volume":"4","author":"Gilron","year":"2019","journal-title":"Pain Rep"},{"key":"2024112512204670000_11.12.e054618.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.07.009"},{"key":"2024112512204670000_11.12.e054618.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002889"},{"key":"2024112512204670000_11.12.e054618.22","doi-asserted-by":"crossref","unstructured":"Ritchie J , Spencer L . Qualitative data analysis for applied policy research. In: Bryman A , Burgess R , eds. Analyzing qualitative data. London: Routledge, 2002: 187\u2013208.","DOI":"10.4324\/9780203413081-14"},{"key":"2024112512204670000_11.12.e054618.23","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2024112512204670000_11.12.e054618.24","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01325"},{"key":"2024112512204670000_11.12.e054618.25","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1177\/0310057X1304100214","article-title":"Patient recollections of perioperative anaesthesia risks","volume":"41","author":"Gillies","year":"2013","journal-title":"Anaesth Intensive Care"},{"key":"2024112512204670000_11.12.e054618.26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ijsu.2011.10.003","article-title":"Evaluation of patient\u2019s understanding and recall of the consent process after open inguinal hernia repairs","volume":"10","author":"Uzzaman","year":"2012","journal-title":"Int J Surg"},{"key":"2024112512204670000_11.12.e054618.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2007.02.016"},{"key":"2024112512204670000_11.12.e054618.28","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jvs.2015.01.041","article-title":"Predicting postoperative delirium after vascular surgical procedures","volume":"62","author":"Visser","year":"2015","journal-title":"J Vasc Surg"},{"key":"2024112512204670000_11.12.e054618.29","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e318295fd50"},{"key":"2024112512204670000_11.12.e054618.30","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.1998.00314.x"},{"key":"2024112512204670000_11.12.e054618.31","first-page":"114","article-title":"Emergency department patient perspectives on the risk of addiction to prescription opioids","volume":"17","author":"Conrardy","year":"2016","journal-title":"Pain Med"},{"key":"2024112512204670000_11.12.e054618.32","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/j.1526-4637.2010.00868.x","article-title":"Reasons for under-use of prescribed opioid medications by patients in pain","volume":"11","author":"Lewis","year":"2010","journal-title":"Pain Med"},{"key":"2024112512204670000_11.12.e054618.33","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(92)90029-B"},{"key":"2024112512204670000_11.12.e054618.34","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/j.1365-2044.1996.tb12556.x","article-title":"Patients\u2019 experiences of patient-controlled analgesia","volume":"51","author":"Taylor","year":"1996","journal-title":"Anaesthesia"},{"key":"2024112512204670000_11.12.e054618.35","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)06315-0"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-054618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T15:21:04Z","timestamp":1732548064000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-054618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,1]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bmjopen-2021-054618"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-054618","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.741286099.793596612","asserted-by":"object"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}