Welcome to PLACEMENT
PLACEMENT is investigating the effect of perineural catheters (PNC) and local anaesthetic infusion on postoperative pain and recovery after major lower limb amputation (MLLA)
Background |
Aims of research |
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Leg amputations are life changing events, often associated with short and long-term pain (e.g. phantom limb pain). This pain may delay recovery, including being able to use an artificial leg. Managing pain after amputation surgery is an important priority for patients and clinicians.
Current pain managementMorphine is a pain-relieving medication that is commonly used after amputation surgery. However, morphine may not be completely effective, and may be associated with side effects, including sickness, confusion, and breathing problems.
Another type of pain management used at some hospitals in the UK is a ‘perineural catheter’ (PNC) - a thin plastic tube placed next to the main leg nerve during amputation surgery. Local anaesthetic is given through the tube for up to 5 days after amputation surgery which may replace some (or all) of the morphine needed, and/or reduce phantom limb pain. |
PLACEMENT is a randomised trial. Half of the participants will be randomly chosen to have a PNC placed during their amputation surgery . The other half of participants will be randomly chosen not to have a PNC placed during their amputation surgery. All participants will receive other pain-relieving medications as needed. Short and long-term pain and other health-related outcomes will be compared between participants who had the PNC and those who did not have the PNC.
Previous researchIn a small ‘feasibility’ trial, we randomised 49 participants to receive the perineural catheter or not receive the catheter. Perineural local anaesthetic catheter after major lower limb amputation trial (PLACEMENT): results from a randomised controlled feasibility trial -ORCA (cardiff.ac.uk) Participants were happy to take part in the feasibility trial and the catheter was found to be safe and easy to use. Participant interviews helped us to design this research which will fully test the use of the catheter and it's value for money.
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PLACEMENT summary Patient and Public Involvement
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Two members of the public are a central part of our research team. 'D' has had two leg amputations: one with and one without a PNC. 'S' lost her father after an amputation. Together, they helped us plan and run our Feasibility trial and plan this larger trial. We also hold focus group for amputees, who have helped us design this trial, by telling us what is important to them about their amputation pain. Our Patient and Public representatives will continue to work with us throughout the trial.
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