Regional Anesthesia Military Battlefield Pain Outcomes Study (RAMBPOS)

Inclusion Criteria:

- 1. Patient suffered a major limb injury during activity related to the OEF/OIF war in
Afghanistan, Iraq, and other areas of Middle East, Europe, and Asia where peace
keeping efforts and training missions are conducted to support the OEF/OIF war. We
have extended our eligibility criteria based on our knowledge that soldiers may be
deployed in numerous areas where conflicts exist, and their injuries are sustained in
similar ways and their care at military hospital theaters, LRMC, and US armed service
military hospitals is no different than those injured in Afghanistan and Iraq. There
is a comparable level of stress, exposure to harm and intensity of combat support in
many areas outside of the direct war zones in Afghanistan and Iraq. We will carefully
evaluate potential participants from other areas on a case by case basis by
conferring with our military colleagues at WRNMMC and Brooke Army Medical Center to
ensure that injury experiences are comparable

- Pt sustained major (requiring hospitalization and surgical intervention) injury (soft
tissue damage, fracture, nerve damage, amputation, etc) to one or more extremities

- Patient's initial hospitalization in the CONUS (Continental United States) was at
Walter Reed National Military Medical Center, Brooke Army Medical Center, or National
Naval Medical Center at Bethesda. Patients transferred from one of the above
hospitals to VA Polytrauma Centers as part of a continuation of care after their
injury will also be eligible

- Received regional anesthesia within 72 hours of injury

Exclusion Criteria:

- Primary major head trauma and diagnosis of traumatic brain injury resulting in
documented, permanent or prolonged cognitive deficits that would preclude
participation in a longitudinal study ** (decreased intellectual capacity, marked
memory deficits, or inability to communicate verbally or in writing)

- Substantial hearing loss without alterative means for communicating in a phone
interview

- Bilateral upper extremity amputation with no alternate means to complete the survey
forms

- Non-English speaking subjects

- Acute care phase of treatment ended MORE than 2 years ago ** Note - if a patient's
cognitive abilities improve to the point where s/he may be able to concentrate,
complete 30 minute phone interviews, answer questions, etc, s/he MAY be eligible for
the study; the research team will be performing a basic cognitive assessment on every
patient who consents to ensure that there are no significant cognitive deficits. Upon
admission to armed services military hospitals following the initial service-related
injury, patients with mild-moderate TBI may not be ready to participate in a study
like this, but within a few weeks, they may recover to the point where participation
is possible.