372 posters, 1 audios, 13 topics, 29 sessions, 1,035 authors, 449 institutions
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51st Annual Regional Anesthesiology and Acute Pain Medicine Meeting
April 16 - 18, 2026 | Phoenix, Arizona
2316309
Implementation of an Amputation Analgesic Care Pathway: A Quality Improvement Analysis
Poster Presenter
Part of Topic
Scientific Abstracts > Regional Anesthesia
Implementation of an Analgesic Amputation Care Pathway: A Quality Improvement Analysis
INTRO
•Pain associated with above and below knee amputations (AKA & BKA) can be severe and challenging to manage
•Predisposes to chronic residual limb pain (RLP) and phantom limb pain (PLP)
•Peripheral nerve catheters (PNC) for AKA and BKA are shown to reduce acute pain and opioid consumption
•Only 40% of BKA/AKA patients offered PNCs pre-pathway at our institution – majority post-op 2o barriers to access
•We developed an analgesic amputation care pathway to increase the use of PNCs at our academic tertiary care center
METHODS
•Goal: Increase the # of lower limb amputation patients receiving a PNC
•Design: A QI project comparing Pre-pathway retrospectively (June 1, 2022- June 30, 2023) and Post-pathway prospectively (Sept 1, 2023 – Sept 30, 2024). Post-pathway patients were followed to POD 28
RESULTS
257 patients (124 pre-pathway, and 133 post-pathway)
The Numbers
•⬆️ PNC use [43.4% absolute = 3.2x relative
DISCUSSION
•Feasible to provide PNCs to >80% of AKAs and BKAs
•Increased overall provision of PNCs by > 40% from baseline, which resulted in significant improvements in early analgesia and opioid consumption
•Pathway did not require deployment of additional resources, but better application of available resources and expertise
Process Success Variables:
•Early APS referral allowed scheduled pre-operative PNC insertion when regional expertise available
•Multiple “back-up” options including surgeon placed blocks
•Supported by: Established APS, regional anesthesia program and buy-in from vascular surgery
•Frequent education and reminders to departments
•Cognitive aid embedded in EHR to facilitate pathway