Combined Local Anesthetic Blockade and Neuromodulation vs Local Anesthetic Blockade Only for Analgesia After Below-knee Amputation: RCT

Inclusion Criteria: * Patients at least 18 years of age * Undergoing below-knee amputation Exclusion Criteria: * Chronic opioid use (daily use within the two weeks before surgery and duration of use of more than four weeks of \> 30 mg of oxycodone per day or \> 50 of morphine milligrams per day) * Neuromuscular deficit of the target nerve(s) * Compromised immune system or concurrent risk of infection based on medical history (e.g., immunosuppressive therapies such as chemotherapy, radiation, sepsis, infection). * Implanted spinal cord stimulator, cardiac pacemaker/defibrillator, deep brain stimulator, or another implantable neurostimulator whose stimulus current pathway may overlap * History of bleeding disorder or chronic antiplatelet or anticoagulation therapies (other than aspirin) that require to be restarted within the first three postoperative days * Allergy to study medications or devices (including occlusive dressings, bandages, tape, etc.) * Incarceration * Pregnancy * Chronic pain for more than three months of any severity in an anatomic location other than the surgical site * Anxiety disorder * History of substance abuse * Inability to consent