Evidence map›Paper›PMID 34853109›Full record

Trial reportBMJ open2021

Exploring patients' experiences of analgesia after major lower limb amputation: a qualitative study.

Sarah Milosevic, Heather Strange, Melanie Morgan, Graeme K Ambler, David C Bosanquet, Cherry-Ann Waldron, Emma Thomas-Jones, Debbie Harris, Christopher P Twine, Lucy Brookes-Howell

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06693427 (Effect of Femoral and Sciatic Nerve Blocks, Combined with General Anesthesia, in Postoperative Pain Levels and Phantom Limb Pain Development in Patients Undergoing Lower Limb Amputation), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06693427 completednot on this map

Effect of Femoral and Sciatic Nerve Blocks, Combined with General Anesthesia, in Postoperative Pain Levels and Phantom Limb Pain Development in Patients Undergoing Lower Limb Amputation

TypeobservationalSponsorDIMITRIOS KATSAROSRan2021 to 2023Enrolled72ConditionsPhantom Limb Pain, Amputation, Anesthesia, LocalArmsPeripheral Nerve Block
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Recovery After Nontraumatic Lower Limb Amputation: A Scoping Review of Longitudinal Research Studies.Archives of rehabilitation research and clinical translation · 2026
    Review
  3. Article
  4. Surgery patients' perspectives of their role in postoperative pain: A scoping review.International journal of nursing studies advances · 2023
    Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Sarah MilosevicCentre for Trials Research, Cardiff University, Cardiff, UK milosevics@cardiff.ac.uk.ORCID 0000-0003-1973-8286
Heather StrangeCentre for Trials Research, Cardiff University, Cardiff, UK.
Melanie MorganCentre for Trials Research, Cardiff University, Cardiff, UK.
Graeme K AmblerDepartment of General Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
David C BosanquetGwent Vascular Institute, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK.
Cherry-Ann WaldronCentre for Trials Research, Cardiff University, Cardiff, UK.ORCID 0000-0001-8465-2492
Emma Thomas-JonesCentre for Trials Research, Cardiff University, Cardiff, UK.
Debbie HarrisCentre for Trials Research, Cardiff University, Cardiff, UK.
Christopher P TwineDepartment of General Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Lucy Brookes-HowellCentre for Trials Research, Cardiff University, Cardiff, UK.
Cardiff University · GBNorth Bristol NHS Trust · GBRoyal Gwent Hospital · GB

Funding

HCRW_ RFPPB-16-1198
6 · The paper itself

Abstract

objectivesTo explore patient experiences, understanding and perceptions of analgesia following major lower limb amputation.

designQualitative interview study, conducted as part of a randomised controlled feasibility trial.

settingParticipants were recruited from two general hospitals in South Wales.

participantsInterview 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.

methodsSemi-structured, face-to-face interviews were conducted with participants over two time points: (1) up to 1 month and (2) at least 6 months following amputation. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach.

resultsInterviews 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.

conclusionsFindings 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. TRIAL REGISTRATION NUMBER: ISRCTN: 85710690; EudraCT: 2016-003544-37.

Indexed as

Amputation, SurgicalPain ManagementAnalgesia, Patient-ControlledAnalgesics, OpioidFemaleHumansLower ExtremityMalePostoperative PainQualitative ResearchAnalgesics, Opioidpain managementqualitative researchvascular surgery

Identifiers

PMID34853109
PMCPMC8638453
OpenAlexW3217596591

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.