Direct Placement of a Brachial Plexus Neural Catheter for Analgesia after Traumatic Upper Limb Amputation

  1. Jeremy Granville-Chapman MRCS1,*,
  2. Mike Tennant FRCA2,
  3. Dominic Aldington FRCA3,
  4. Steven Rhodes Smith FRCS (Tr&Orth)4,
  5. David Malcolm Nott FRCS5

Article first published online: 1 JUN 2009

DOI: 10.1111/j.1526-4637.2009.00638.x

Issue

Pain Medicine

Pain Medicine

Volume 10, Issue 6, pages 1132–1135, September 2009

Additional Information

How to Cite

Granville-Chapman, J., Tennant, M., Aldington, D., Smith, S. R. and Nott, D. M. (2009), Direct Placement of a Brachial Plexus Neural Catheter for Analgesia after Traumatic Upper Limb Amputation. Pain Medicine, 10: 1132–1135. doi: 10.1111/j.1526-4637.2009.00638.x

Author Information

  1. 1

    Frimley Park Hospital, Camberley;

  2. 2

    Plymouth, Derriford Hospital, Plymouth;

  3. 3

    John Radcliffe Hospital, Oxford;

  4. 4

    Derriford Hospital, Plymouth;

  5. 5

    Hammersmith Hospital, London, UK

*Jeremy Granville-Chapman, MRCS, Frimley Park Hospital—Trauma and Orthopaedics, Portsmouth Road Frimley, Camberley Gu16 7UJ, UK. Tel: +441276604604; E-mail: jgchapman@doctors.org.uk.

Publication History

  1. Issue published online: 16 SEP 2009
  2. Article first published online: 1 JUN 2009

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Keywords:

  • Acute Pain;
  • Nerve Block;
  • Pain Management;
  • Postoperative Pain;
  • Trauma

ABSTRACT

We report a case of traumatic upper limb injury that resulted in above elbow amputation. A multimodal approach was employed to optimize postoperative analgesia; this included continuous peripheral nerve blockade, initiated intraoperatively. Surgical access onto the axillary artery for proximal vascular control allowed placement of the nerve catheter under direct vision onto the brachial plexus. The pathophysiology of phantom pain is related to our case experience. This report highlights the complex challenge of controlling pain in combat casualties and promotes employment of multimodal analgesic strategies, including advanced regional anesthesia, in the military setting.

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