Most patients have more than one mode of pain control after surgery--usually some combination of epidural anesthesia, perineural anesthesia and intravenous morphine. With this regimen, our patients usually have minimal post-operative pain.

Perineural (also called "epineural") analgesia is the use of a small catheter, inserted at the time of surgery, to deliver a continuous infusion of non-narcotic anesthetic directly onto the nerve supplying the surgical area.

The use of perineural analgesia for limb-sparing surgery was pioneered by the Washington Musculoskeletal Tumor Center. We have routinely used perineural analgesia for over a decade and found that it significantly reduces patients' pain and their need for narcotics.