THERAPUTIC ALTERNATIVES FOR PHANTOM LIMB PAIN FOLLOWING SURGERY

2018 ◽  
Vol 64 (1) ◽  
pp. 126-130
Author(s):  
Alla Ryazankina ◽  
Aleksey Karelov ◽  
Vladimir Glushchenko ◽  
S. Rozengard ◽  
M. Rogachev
Keyword(s):  
Adenosine Triphosphate ◽  
Epidural Anesthesia ◽  
Postoperative Analgesia ◽  
Phantom Limb Pain ◽  
Mechanisms Of Action ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain ◽  
Pain Mechanisms ◽  
Weak Opioid

A study of different analgesic methods for phantom limb pain has been performed in 35 patients who had undergone limb amputation or exarticulation because of oncological disease or vascular disorders. Postoperative analgesia consisted of cyclooxygenese inhibitor and weak opioid. High intensive phantom limb pain appeared in 17 (48.6%) patients that required an administration of pregabalin followed by adenosine triphosphate infusion as analgotesting procedure: it had a success in 9 (52.9%) patients. Remaining 6 patients received nefopam that was effective in 5 of 8 (65.5%) patients. Epidural anesthesia was used with good results in remaining 3 patients. Thus, our data emphasize the complex of phantom limb pain mechanisms and necessity of study for elaboration of medicine effectiveness with different mechanisms of action for such cases.

scholarly journals Development of a Multimodal Analgesia Protocol for Perioperative Acute Pain Management for Lower Limb Amputation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Roberta De Jong ◽  
Alexander J. Shysh
Keyword(s):  
Pain Management ◽  
Lower Limb ◽  
Phantom Limb Pain ◽  
Multimodal Analgesia ◽  
Lower Limb Amputation ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Multiple Sources ◽  
Limb Pain ◽  
Pain Mechanisms

Multimodal analgesia may include pharmacological components such as regional anesthesia, opioid and nonopioid systemic analgesics, nonsteroidal anti-inflammatories, and a variety of adjuvant agents. Multimodal analgesia has been reported for a variety of surgical procedures but not yet for lower limb amputation in vasculopathic patients. Perioperative pain management in these patients presents a particular challenge considering the multiple sources and pathways for acute and chronic pain that are involved, such as chronic ischemic limb pain, postoperative residual limb pain, coexisting musculoskeletal pain, phantom limb sensations, and chronic phantom limb pain. These pain mechanisms are explored and a proposed protocol for multimodal analgesia is outlined taking into account the common patient comorbidities found in this patient population.

Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain

2004 ◽  
Vol 26 (14-15) ◽  
pp. 882-893 ◽  
Author(s):  
Marisol A Hanley ◽  
Mark P Jensen ◽  
Dawn M Ehde ◽  
Amy J Hoffman ◽  
David R Patterson ◽  
...  
Keyword(s):  
Lower Limb ◽  
Phantom Limb Pain ◽  
Lower Limb Amputation ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Psychosocial Predictors ◽  
Limb Pain

scholarly journals Phantom Limb Pain: Low Frequency Repetitive Transcranial Magnetic Stimulation in Unaffected Hemisphere

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Andrea Di Rollo ◽  
Stefano Pallanti
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Pain Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain

Phantom limb pain is very common after limb amputation and is often difficult to treat. The motor cortex stimulation is a valid treatment for deafferentation pain that does not respond to conventional pain treatment, with relief for 50% to 70% of patients. This treatment is invasive as it uses implanted epidural electrodes. Cortical stimulation can be performed noninvasively by repetitive transcranial magnetic stimulation (rTMS). The stimulation of the hemisphere that isn't involved in phantom limb (unaffected hemisphere), remains unexplored. We report a case of phantom limb pain treated with 1 Hz rTMS stimulation over motor cortex in unaffected hemisphere. This stimulation produces a relevant clinical improvement of phantom limb pain; however, further studies are necessary to determine the efficacy of the method and the stimulation parameters.

scholarly journals Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies

2017 ◽  
Vol 15 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Sarah C. Griffin ◽  
Sean Curran ◽  
Annie W.Y. Chan ◽  
Sacha B. Finn ◽  
Chris I. Baker ◽  
...  
Keyword(s):  
Pain Relief ◽  
Short Form ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Mcgill Pain Questionnaire ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Experienced Pain ◽  
Pain Symptoms

AbstractBackground and purposeResearch indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy.MethodsData from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n = 33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire.ResultsThe severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (p < 0.05) in PLP by session 7 of treatment, those with medium baseline PLP experienced pain relief by session 14 of treatment, and those with high baseline PLP experienced pain relief by session 21 of treatment. Mirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms.ConclusionThe degree of PLP at baseline predicts when mirror therapy relieves pain.ImplicationsThis article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain.

scholarly journals Immersive VR in Phantom Limb Pain Therapy of Amputee Patients Due to Critical Limb Ischemia

2017 ◽  
Vol 63 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Ana-Maria Zanfir ◽  
Domnita Ilea Georgescu ◽  
Sergiu Cristian Turturica ◽  
Mihaela Eczedi ◽  
Aurel Mironiuc
Keyword(s):  
Coping Strategies ◽  
Intervention Program ◽  
Pain Catastrophizing ◽  
Life Quality ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Depression Symptoms ◽  
Mirror Therapy ◽  
Limb Pain

AbstractIntroduction: Phantom limb pain (PLP) occurs in approximately 75% of patients who undergo limb amputation. In identifying the etiopathogenic mechanisms, multidisciplinary approaches are increasingly important in explaining the causality based on neurological and psychological factors. PLP has many negative effects on the amputee's physical and mental integrity, which is why a variety of treatments have been conceived, whose effectiveness is rather limited.Objective:The purpose of this study is to evaluate the effectiveness of an immersive virtual reality (IVR) intervention program using the mirror therapy principles in decreasing PLP.Method: Twenty participants suffering from PLP were randomly assigned to one of the two intervention groups: IVR and kinesiotherapy, respectively. Pre- and post-intervention measurements were performed both on pain level and on several psychological variables: depression and anxiety symptoms, pain catastrophizing, quality of life, body representation and coping strategies.Results: Preliminary data show a significant pain relief in patients in the IVR group compared to those in the kinesiotherapy group. Besides, significant improvement was found in the case of the patients in the IVR group, in terms of life quality improvement, reducing irrational pain catastrophizing-related thoughts and positive coping strategies (positive refocusing and reappraisal). There were no differences identified between the two groups in terms of anxiety and depression symptoms. Despite expectations, patients in the IVR group experienced a significant increase in one negative coping strategy: rumination.Conclusions: The results obtained are advocating the use of IVI intervention as a method phantom limb pain alleviation, with positive consequences on patients' life quality.

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