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The Regional Anaesthesia and Acute Pain Service team at Newcastle’s Freeman Hospital have been named as finalists for a prestigious BMJ award, in the “Anaesthesia and Peri-operative Medicine Team” category.

Shortlisted for their proactive and radical approach to responding to the need for more effective pain management of post amputation surgery, the team are delighted to be recognised in this national arena against some tough competition.

Patients requiring lower limb amputation as a result of vascular disease are often admitted critically unwell and in severe pain. An increasing dilemma is many patients reporting that their pain was not well controlled, and that they were in need of a combination of intravenous (IV) opioids and oral pain relief.

A multi disciplinary approach was taken to demonstrate that continuous peripheral nerve blockade if given during and after surgery, could offer an effective reduction in post amputation pain and with benefits lasting up to 12 months post operatively.

Dr Rita Singh, a Consultant anaesthetist at the Freeman Hospital explains: “As a tertiary referral vascular centre we provide specialist care for patients who need amputation through either planned or emergency surgery. As such, we were able to approach this issue using a huge wealth of expertise and knowledge amongst our vascular surgeons, Pain nurses, Physiotherapists and Occupational therapists as well as increasing experience of Regional anaesthetists.

She adds: “We started by reviewing all our historic findings to create a plan to develop a simple pathway for all planned amputations where we could encourage and support patients with all stakeholders involved.  

Data was collected for all patients during January 2017 to November 2018, and compared to data from 2014-16. The results and patient feedback was encouragingly positive.

Dr Martin Jones, Consultant anaesthetist and team leader adds: “This project has been unique as the peri neural catheter stay for 7 days avoiding the need for using very strong morphine-based medication and the related side effects especially in this vulnerable group of patients. Controlling pain with peri neural catheters has benefitted in facilitating nursing care on the ward, Physiotherapy and early rehabilitation.

Angela Telford, Pain Nurse Specialist continues: “We have found that the percentage of patients requiring additional analgesia   post-operatively has reduced from 70% to 10% whilst on a local anaesthetic infusion via catheter.  

She adds: “Another added bonus has been the development of better relationships with our patients and their families through close, ongoing discussions about their care, and we’re delighted to see that most of them have reported greater pain control.”

Good luck to the team at the BMJ Awards ceremony on Wednesday 24^th April 2019.

Find out more at www.thebmjawards.bmj.com/shortlist-2019