Major lower extremity amputations (above knee amputation or below knee amputation) are common procedures performed for patients with end stage ischemia, infection, and/or disfiguration. Patients undergoing major lower extremity amputations have significant morbidity and mortality. Up to 95% of amputees report chronic pain, and inadequate pre- and postoperative pain control may increase the risk of chronic amputation pain. Additionally, there is a growing epidemic of narcotic overdoses in the United States. From 2000 to 2014, the age-adjusted drug overdose death rate has more than doubled from 6.2 per 100,000 persons to 14.7 per 100,000. The main drugs associated with overdose deaths are prescription pain medications.