scholarly journals Botulinum toxin therapy in amputee pain management

2018 ◽  
Vol 87 (1) ◽  
pp. 42-45
Author(s):  
Ramona Neferu ◽  
Ricardo Viana ◽  
Tom Miller ◽  
Michael Payne
Keyword(s):  
Botulinum Toxin ◽  
Pain Management ◽  
Case Reports ◽  
Case Series ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Cochrane Library ◽  
Future Research ◽  
Limb Pain ◽  
Botulinum Toxin Therapy

Background: Post-amputation pain is common, occurring in up to 85% of patients. The pain can be related to the etiology of amputation, post-surgical healing, or prosthetic use. Pain syndromes may arise from a variety of tissue pathologies and can be broadly categorized into residual limb pain (RLP) or phantom limb pain (PLP). Botulinum toxin (BTX) has been found to be effective in treating a variety of neuropathic pain conditions. This scoping review summarizes the use of BTX in RLP and PLP management of patients with a major extremity amputation. Methods: A literature search was conducted using PubMed, Web of Science, Cochrane Library, Scopus, and Google Scholar. Sixteen studies were included. Most studies excluded did not address BTX use in amputee pain management. Extracted data were categorized by either RLP or PLP. Results: Two randomized controlled trials (RCTs), 10 case series, and 4 case reports were included (total 68 patients, 82 amputations). Seven studies addressed BTX use in both RLP and PLP, 5 studies address RLP exclusively, and 5 additional studies exclusively addressed PLP. Toxin types, injection techniques, and dosages varied between the studies. Negative results were reported in 2 RCTs and 2 case series showing 30% of patients with RLP and 50% patients with PLP did not benefit from BTX. Conclusion: Literature for BTX in PLP and RLP is broad but lacking rigour for definitive conclusions to guide usage. There were more positive results for BTX use in RLP than in PLP. Case reports and patient series show promising results for both PLP and RLP, indicating future research should be directed at adequately-powered prospective trials.

Botulinum toxin to treat Phantom limb pain

Toxicon ◽  
2021 ◽  
Author(s):  
Arunmozhimaran Elavarasi ◽  
Vinay Goyal
Keyword(s):  
Botulinum Toxin ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain

Interventional pain management for phantom limb pain: An algorithmic approach

2012 ◽  
Vol 16 (4) ◽  
pp. 201-204
Author(s):  
Santiago Jaramillo ◽  
Lizeth Jazmin Ramirez ◽  
Carlos Eduardo Restrepo-Garces ◽  
Carlos Mario Gómez B ◽  
Juan Felipe Vargas Silva
Keyword(s):  
Pain Management ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Algorithmic Approach ◽  
Interventional Pain Management

Preamputation Mirror Therapy May Prevent Development of Phantom Limb Pain: A Case Series

2010 ◽  
Vol 110 (2) ◽  
pp. 611-614 ◽  
Author(s):  
Steven R. Hanling ◽  
Scott C. Wallace ◽  
Kerry J. Hollenbeck ◽  
Brian D. Belnap ◽  
Matthew R. Tulis
Keyword(s):  
Case Series ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Limb Pain

scholarly journals Decreasing Phantom Limb Pain Through Observation of Action and Imagery: A Case Series

Pain Medicine ◽  
2011 ◽  
Vol 12 (2) ◽  
pp. 289-299 ◽  
Author(s):  
Geneviève Beaumont ◽  
Catherine Mercier ◽  
Pierre-Emmanuel Michon ◽  
Francine Malouin ◽  
Philip L. Jackson
Keyword(s):  
Case Series ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain

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.

scholarly journals Reduction of Phantom Limb Pain and Improved Proprioception through a TSR-Based Surgical Technique: A Case Series of Four Patients with Lower Limb Amputation

2021 ◽  
Vol 10 (17) ◽  
pp. 4029
Author(s):  
Alexander Gardetto ◽  
Eva-Maria Baur ◽  
Cosima Prahm ◽  
Vinzenz Smekal ◽  
Johannes Jeschke ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Sensory Nerve ◽  
Case Series ◽  
Phantom Limb Pain ◽  
Pain Medication ◽  
Sensory Nerves ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Skin Area ◽  
Limb Pain

Four patients underwent targeted sensory reinnervation (TSR), a surgical technique in which a defined skin area is first selectively denervated and then surgically reinnervated by another sensory nerve. In our case, either the area of the lateral femoral cutaneous nerve or the saphenous nerve was reinnervated by the sural nerve. Patients were then fitted with a special prosthetic device capable of transferring the sense of pressure from the sole of the prosthesis to the newly wired skin area. Pain reduction after TSR was highly significant in all patients. In three patients, permanent pain medication could even be discontinued, in one patient the pain medication has been significantly reduced. Two of the four patients were completely pain-free after the surgical intervention. Surgical rewiring of existing sensory nerves by TSR can provide the brain with new afferent signals seeming to originate from the missing limb. These signals help to reduce phantom limb pain and to restore a more normal body image. In combination with special prosthetic devices, the amputee can be provided with sensory feedback from the prosthesis, thus improving gait and balance.

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