Although bupivacaine is widely used for pain control, there are very few studies looking at regional nerve blocks as adjuncts for pain control after major lower extremity amputations. The number of randomized controlled trials is even fewer and none have been conducted in the United States. Baddoo looked at ten patients undergoing major lower extremity amputations (nine above knee amputations and one below knee amputation) with regional nerve blocks (a sciatic nerve block combined with either a 3-in-1 block or a psoas compartment lumbar plexus block). All ten patients were hemodynamically stable throughout surgery. Seven patients had good block, and three patients had fair block. Bech et al. presented a case report of four patients with severe cardiac insufficiency where they successfully utilized peripheral nerve blocks for trans-femoral amputation. The first patient was an 88-year-old man with American Society of Anesthesiologists (ASA) class 4. His echocardiogram showed an ejection fraction of 10%, mitral valve insufficiency and aortic valve sclerosis. The second patient was a 90-year-old woman with ASA class 4. Her echocardiogram showed an ejection fraction of 25% and severe mitral valve insufficiency. The third patient was a 64-year-old man with ASA class 4. His echocardiogram showed an ejection fraction of 25%, mitral valve insufficiency and tricuspid valve insufficiency. The fourth patient was a 74-year-old man with ASA class 4. His echocardiogram showed an ejection fraction of 15%, right-sided heart failure and both mitral and aortic valve insufficiency. All patients had successful outcomes in the postoperative course. Palkhiwala et al. looked at combined femoral and sciatic nerve blocks for lower limb procedures. With a randomized study involving 50 patients, they concluded that combined femoral and sciatic nerve blocks are effective for pain control with very low incidence of side effects. Forty-six out of fifty patients had complete block, and none of the patients had any cardiovascular or neurologic adverse events. Our study design is one of the first randomized controlled trials that looks at the effect of regional nerve blocks on postoperative pain and length of hospital stay.