From Battlefield to Recovery: Continuous Regional Anaesthesia for War-Related Lower Limb Trauma

War-related lower limb trauma represents one of the most frequent and severe injury patterns in modern armed conflicts. Blast injuries, gunshot wounds, and complex soft-tissue damage often result in severe acute pain requiring repeated surgical procedures, prolonged hospitalization, and intensive rehabilitation.

Adequate pain management in this population is critical not only for immediate patient comfort but also for facilitating wound care, early mobilization, rehabilitation participation, and potentially reducing the risk of long-term pain syndromes.

Continuous regional anaesthesia (CRA), delivered through ultrasound-guided peripheral nerve catheters, allows prolonged targeted analgesia by continuous infusion of local anesthetics. Compared with systemic analgesia or single-shot regional blocks, CRA may provide superior and sustained pain control, reduce opioid exposure, and improve rehabilitation tolerance.

However, evidence regarding the effectiveness of continuous regional anaesthesia in war-related lower limb trauma remains limited, particularly in real-world trauma settings involving blast injuries and multi-stage reconstructive surgery.

This study aims to evaluate the effectiveness and safety of continuous regional anaesthesia compared with standard analgesic strategies in patients with war-related lower limb trauma.

Inclusion criteria

• age ≥18 years
• war-related lower limb trauma
• hospital admission requiring surgical treatment or wound management
• documented pain assessment during hospitalization
• availability of analgesic treatment data
• informed consent where required

Exclusion criteria

• age <18 years
• isolated upper limb trauma
• missing key pain outcome data
• contraindication to regional anaesthesia prior to treatment
• refusal to participate (for prospective component)