Steen T, et al. - In this retrospective cohort analysis of opioid-naïve patients who underwent limb amputation, researchers determined the incidence of preoperative opioid usage as well as the incidence and risk factors for new persistent postoperative opioid usage. Participants aged 18 years and older and were undergoing upper or lower extremity amputations in Landspitali University Hospital from 2005 to 2015. Total patients were 328, of these, opioid naïve and chronic opioid users were 216 (66%) and 112 (34%), respectively. Younger age, male gender, preoperative use of neuropathic medications or benzodiazepines and lower (opposed to upper) extremity amputation showed an independent relation to persistent postoperative opioid usage, as revealed in multivariate analysis. A 20% likelihood of having a persistent opioid need after surgery was observed in opioid naïve patients undergoing major amputation. This could signify new-onset phantom limb pain or other chronic pain. To decrease the load of chronic pain following limb amputations, perioperative multimodal efforts in this direction should be prompted by these observations.