Pain management after amputation of lower limb

Article Sidebar

PDF
Published: Jun 23, 2023
Keywords:
Pain, Analgesia, Amputation, Phantom limb

Main Article Content

Manjaree Mishra
Associate Professor, Department of Anesthesiology (Trauma Centre), Institute of Medical Sciences, Banaras Hindu University, Varanasi. UP.
Vivek K. Katiyar
Assistant Professor, Department of General Surgery (Trauma Centre), Institute of Medical Sciences, Banaras Hindu University, Varanasi. UP.
Sumit Sharma
Assistant Professor, Department of General Surgery (Trauma Centre), Institute of Medical Sciences, Banaras Hindu University, Varanasi. UP.
Ram Niwas Meena
Professor, Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi. UP.
Rahul Khanna
Professor, Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi. UP.
Shashi Prakash Mishra
Associate Professor of Surgery, IMS BHU

Abstract

Pain remains a very important issue which needs to be addressed after amputation of lower limb. There are may pharmacological agents available and many procedures which can be used to give pain relief to these patients but with varying degree of acceptability and success.


The current review article discusses about the challenges related to the management of pain after amputation of lower limb and recent trends in this field.  

Article Details

How to Cite
Mishra, M., Katiyar, V. K., Sharma, S. ., Meena, R. N. ., Khanna, R. ., & Mishra, S. P. (2023). Pain management after amputation of lower limb . Journal of Surgery Archives, 1(02), 13–20. Retrieved from https://jsurgarchives.com/index.php/ijsa/article/view/45
Issue
Vol. 1 No. 02 (2023): JOURNAL OF SURGERY ARCHIVES
Section
Review Articles

References

Wong MWN, 2005 Lower extremity amputation in Hong Kong, Hong Kong Medical Journal, 11(3): 147-152

The Global Lower Extremity Amputation (GLEA) Study Group , 2000 Epidemiology of lower extremity amputation in centers in Europe, North America and East Asia, British Journal of Surgery, 87(3): 328-37

Eiser C, Darlington A-S E, stride CB, Grimer R, 2001 Quality of life implications as a consequence of surgery: limb salvage, primary and secondary amputation, Sarcoma, 5: 189-195

Taylor SM, Kalbaugh CA, Blackhusrt DW, Hamontree SE, Cull DL, Messich HS, Robertson RT, Langan EM, York JW, Carsten CG, Snyder BA, Jackson MR, Youkey JR, 2005 Preoperative clinical factors predict postoperative functional outcomes after major lower limb amputation: An analysis of 553 consecutive patients, Journal of Vascular Surgery, 42(2):227-234

Hagberg, K, and R Brånemark. "Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems." Prosthet Orthot Int, 2001: 186-194.

Flor, H. "Phantom-limb pain: characteristics, causes, and treatment." Lancet Neurology, 2002: 182-189.

Hill, A. "Phantom limb pain: a review of the literature on attributes and potential mechanisms." J Pain Symptom Manag, 1999: 125-142.

Axoiti, A.-M., Geramani, E., Sarbu, V., & Karamanou, M. (2014). Historical Notes Ambroise Pare- Founder of Modern Surgery and Pioneer of Military Medicine. Journal of Surgical Sciences, 1(3), 145–148.

Richardson, C. (2010). Phantom Limb Pain; Prevalence, Mechanisms and Associated Factors. In C. Murray (Ed.), Amputation, Prosthesis Use, and Phantom Limb Pain (p. 137). New York: Springer Berlin Heidelberg. https://doi.org/10.1007/978-0-387-87462-3

Furukawa, T. (1990). Charles Bell’s description of the phantom phenomenon in 1830. Neurology, 40(12), 1830. https://doi.org/10.1212/WNL.40.12.1830

Nikolajsen, L., & Jensen, T. S. (2001). Phantom limb pain. British Journal of Anaesthesia, 87(1), 107–116. https://doi.org/10.1093/bja/87.1.107

Edwards, D. S., Mayhew, E. R., & Rice, A. S. C. (2014). “doomed to go in company with miserable pain”: Surgical recognition and treatment of amputation-related pain on the Western Front during World War 1. The Lancet, 384(9955), 1715–1719. https://doi.org/10.1016/S0140-6736(14)61643-3

Foote, C. E., Kinnon, J. Mac, Robbins, C., Pessagno, R., & Portner, M. D. (2015). Longterm health and quality of life experiences of Vietnam veterans with combat-related limb loss. Quality of Life Research, 24(12), 2853–2861.https://doi.org/10.1007/s11136-015-1029-0

Heszlein-Lossius, H. E., Al-Borno, Y., Shaqqoura, S., Skaik, N., Giil, L. M., & Gilbert, M. (2018). Life after conflict-related amputation trauma: a clinical study from the Gaza Strip. BMC International Health and Human Rights, 18(1), 34. https://doi.org/10.1186/s12914-018-0173-3

Henderson, W. R., & Smyth, G. E. (1948). Phantom limbs. Journal of Neurology, Neurosurgery, and Psychiatry, 11(2), 88–112. https://doi.org/10.1136/jnnp.11.2.88

Argoff, CE, and HS Smith. "Phantom Pain." In Management of Pain, by JC Ballantyne, 331-338. New York: Lippincott Williams & Wilkins, 2010.

Gutnick, M, and PD Wall. "Ongoing activity in peripheral nerves: the physiology and pharmacology of impulses originating from a neuroma." Exp Neurol, 1974: 580-593.

Burchiel, KJ, and LC Russell. "Has the amount of spontaneous electrical activity in experimental neuromas been overestimated?" Somatosens Res, 1987: 63-75.

Devor, M, R Govrin-Lippmann, and K Angelides. "Na channels immunolocalization in the peripheral mammalian axons and changes following nerve injury and neuroma formation." J Neuroscience, 1993: 1976-1992.

Devor, M, W Jänig, and M Michaelis. "Modulation of activity in dorsal root ganglion neurones by sympathetic activation in nerve injured rats." J Neurophysiol, 1994: 38-47.

Zhang, JM, H Li, and SJ Brull. "Perfusion of the mechanically compressed lumbar ganglion with lidocaine reduces mechanical hyperalgesia and allodynia in the rat." J Neurophysiol, 2000: 798-805.

Spichler ERS, Spichler D, Lessa I, Costa e Forti A, Franco LJ, LaPorte ER, 2001 Capture-recapture method to estimate lower-extremity amputation rates in Rio de Janeiro, Brazil, Pan American Journal of Public Health, 10(5): 334-340.

Eskelinen E, Lepantalo M, Hietala EM, Sell H, Kauppila L, Maenpaa I, Pitkanen J, Salminen-Peltola P, Leutola S, Eskilinen A, Kiviola A, Tukiainen E, Lukinmaa A, Brasken P, Railo M, 2004 Lower extremity amputations in Finland in 2000 and trends up to 2001, European Journal of Vascular and Endovascular Surgery, 27 (2): 193-200

Abou-Zamzam AM, Teruya TH, Killen D, Ballard JL, 2003 Major lower extremity amputation in an Academic Vascular Center, Annals of Vascular Surgery, International Journal of Vascular Surgery, 17(1): 86-90

Moss SE, Klien R, Klien BEK, 1999: The 14-year incidence of lower extremity amputations in a diabetic population, Diabetes Care, 22(6): 951-959

Calle-Pascual AL, Redondo MJ, Ballesteros M, Martinez-Salinas MA, Diaz JA, De Matis P, Calle JR, Gil E, Jimenez M, Serrano FJ, Martinez-Alvarez PJ, Maranes JP, 1997 Nontraumatic lower extremity amputations in diabetic and non-diabetic subjects in Madrid, Spain, Diabetes & Metabolism, 23: 519-523

Godlwana L, Nadasan T, Puckree T, 2008 Global trends in incidence of lower limb amputation: A review of the literature. South African Journal of Physiotherapy, 64 (1): 8-11

phraim, PL, ST Wegener, EJ MacKenzie, TR Dillingham, and LE Pezzin. "Phantom pain, residual pain and back pain in amputees: Results of a Nationaly survey." Arch Phys Med Rehabil, 2005: 1910-1919.

Hanley, MA, DM Ehde, M Jensen, J Czerniecki, and DG Smith. "Chronic Pain Associated with Upper-limb Loss." Am. J. Phys. Med. Rehabil, 2009: 742-751.

Ehde, D. M., Czerniecki, J. M., Smith, D. G., Campbell, K. M., Edwards, W. T., Jensen, M. P., & Robinson, L. R. (2000). Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Archives of Physical Medicine and Rehabilitation, 81(8), 1039–1044.

Ribera, H. "Phantom limb pain secondary to post-traumatic stump hematoma 40 years after amputation: description of one case." Revista de la Soceidad Espanola del Dolor, 2001: 217-220.

Jensen, M. P., Karoly, P., & Braver, S. (1986). The measurement of clinical pain intensity: a comparison of six methods. Pain, 27(1), 117–126.

Wartan, SW. "Phantom pain and sensation among British veteran amputees." Br J Anesth, 1997: 652-659.

Alviar, M., Dungca, M., & Hale, T. (2016). Pharmacologic interventions for treating phantom limb pain. Cochrane Database of Systematic Reviews: Protocols, (1), 1–52.

Wilder-Smith, CH, LT Hill, and S Laurent. "Postamputation pain and sensory changes in treatment-naive patients: characteristics and responses to treatment with tramadol, amitriptyline, and placebo." Anesthesiology, 2005: 619-628.

Roullet, S, K Nouette-Gaulain, M Biais, and N Bernard. "Preoperative opioid consumption increases morphine requirement after leg amputation." Can J Anesth, 2009: 908-913.

Lambert, AW, AK Dashfield, C Cosgrove, and DC Wilkins. "Randomized prospective study comparing preoperative epidural and intraoperative perineural analgesia for the prevention of postoperative stump and phantom limb pain following major amputation." Reg Anesth Pain Med, 2001: 216-221.

Peterson, D. "Neuropathic Pain Pharmacotherapy." In Management of Pain, by J Ballantyne, 1194-1207. New York: Lippincott Williams & Wilkins, 2010.

Hayes, A. "Perioperative intravenous ketamine infusion for the prevention of persistent post-amputation pain: a randomized, controlled trial." Anaesth Intensive Care, 2004: 330-338.

Nikolajsen, L. "The effect of ketamine on phantom pain: central neuropathic disorder maintained by peripheral input." Pain, 1996: 69-77.

Felsby, S, J Nielsen, L Arendt-Nielsen, and TS Jensen. "NMDA receptor blockade in chronic neuropathic pain: a comparison of ketamine and magnesium chloride." Pain, 1996: 283-291.

Eichenberger, U, F Neff, G Sveticic, and S Björgo. "Chronic phantom limb pain: the effects of calcitonin, ketamine and their combination on pain and sensory thresholds." Anesth Anal, 2008: 1265-1273.

Maier, C, R Dertwinkel, N Mansourian, and I Hosbach. "Efficacy of the NMDA receptor antagonist memantine in patients with chronic phantom limb pain-results of a randomized, double-blinded, placebo-controlled trial." Pain, 2003: 277-283.

Hanley, M. A., Ehde, D. M., Campbell, K. M., Osborn, B., & Smith, D. G. (2006). Selfreported treatments used for lower-limb phantom pain: Descriptive findings. Archives of Physical Medicine and Rehabilitation, 87(2), 270–277.

Sukhtankar, D. D., Lee, H., & Rice, K. C. (2014). Differential effects of opioid-related ligands and NSAIDs in nonhuman primate models of acute and inflammatory pain, 1377–1387. https://doi.org/10.1007/s00213-013-3341-0

Sharma, C. V, & Mehta, V. (2014). Paracetamol : mechanisms and updates. Continuing Education in Anaesthesia Critical Care & Pain, 14(4), 153–158.

Finnoff, J. "Differetiation and treatment of Phantom sensation, phantom pain and residual limb pain." J Am Podiatr Med Assoc, 2001: 23-33.

Kuiken, TA, L Schechtman, and RN Harden. "Phantom limb pain treatment with mirtazapine: a case series." Pain Pract, 2005: 356-360.

Kashani JH, Frank RG, Kashani SR, Wonderlich SA, Reid MA, Ried C, 1983 Depression among amputees, Journal of Clinical Psychiatry, 44 (7):256-58

Rowbotham, MC. "Treatment response in anti-depressant-naive postherpetic neuralgia patients: double blind, randomized trial." J Pain, 2005: 741-746.

Dworkin, RH, AB O'Connor, M Backonja, JT Farrar, and NB Finnerup. "Pharmacologic management of neuropathic pain: evidence-based recommendations." Pain, 2007: 237-251.

Robinson, LR, JM Czerniecki, DM Ehde, and WT Edwards. "Trial of amitriptyline for relief of pain in amputees: results of a randomized controlled study." Arch Phys Med Rehab, 2004: 1-6.

Flor H, Nikolajsen L, Staehelin Jensen T. Phantom limb pain: a case of maladaptive CNS plasticity? Nat. Rev. Neurosci. 7(11), 873–881 (2006).

Bone, M, P Critchley, and DJ Buggy. "Gabapentin in postamputation limb pain: a randomized, double-blind, placebo-controlled, cross-over study." Reg Anesth Pain Med, 2002: 481-486.

Patterson, JF. "Carbamzepine in the treatment of phantom limb pain." J South Med, 1988: 1100-1102.

Ramachandran, V. S., & Blakeslee, S. (1998). Phantoms in the Brain: Probing the Mysteries of the Human Mind. New York: HarperCollins Books.

Bonassi, G., Pelosin, E., Ogliastro, C., Cerulli, C., Abbruzzese, G., & Avanzino, L. (2016). Mirror visual feedback to improve bradykinesia in Parkinson’s disease. Neural Plasticity, 2016. https://doi.org/10.1155/2016/8764238

Pérez-Cruzado, D., Merchán-Baeza, J. A., González-Sánchez, M., & Cuesta-Vargas, A. I. (2017). Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors. Australian Occupational Therapy Journal, 64(2), 91–112. https://doi.org/10.1111/1440-1630.12342

Timms, J., & Carus, C. (2015). Mirror therapy for the alleviation of phantom limb pain following amputation: A literature review. International Journal of Therapy and Rehabilitation, 22(3), 135–145. https://doi.org/10.12968/ijtr.2015.22.3.135

Dall, C. H., Gustafsson, F., Christensen, S. B., Dela, F., Langberg, H., & Prescott, E. (2015). Effect of moderate- versus high-intensity exercise on vascular function, biomarkers and quality of life in heart transplant recipients: A randomized, crossover trial. Journal of Heart and Lung Transplantation, 34(8), 1033–1041. https://doi.org/10.1016/j.healun.2015.02.001

Foell, J., Bekrater-Bodmann, R., Diers, M., & Flor, H. (2014). Mirror therapy for phantom limb pain: Brain changes and the role of body representation. European Journal of Pain (United Kingdom), 18(5), 729–739. https://doi.org/10.1002/j.1532-2149.2013.00433.x

Barbin, J., Seetha, V., Casillas, J. M., Paysant, J., & Pérennou, D. (2016). The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review. Annals of Physical and Rehabilitation Medicine, 59(4), 270–275. https://doi.org/10.1016/j.rehab.2016.04.001

Casale, R., Damiani, C., & Rosati, V. (2009). Mirror therapy in the rehabilitation of lower-limb amputation: Are there any contraindications? American Journal of Physical Medicine and Rehabilitation, 88(10), 837–842. https://doi.org/10.1097/PHM.0b013e3181b74698

Sherman, R. A., Sherman, C. J., & Parker, L. (1984). Chronic phantom and stump pain among american veterans: results of a survey. Pain, 18(1), 83–95. https://doi.org/10.1016/0304-3959(84)90128-3

Blankenbaker, WL. "The care of patients with phantom limb painin a pain clinic." Anesth Analg, 1977: 842-846.

Halbert, J. "Evidence for the optimal management of acute and chronic phantom pain: systematic review." Clin J Pain, 2002: 84-92.

Prantl, L, S Schreml, N Heine, and M Eisenmann-Klein. "Surgical treatment of chronic phantom limbsensation and limb pain after lower limb amputation." Plast Recontr Surg, 2006: 1562-1572.

Sturm, V, M Kröger, and H Penzholz. "Problems of peripheral nerve surgery in amputation stump pain and phantom limbs." Chirurg, 1975: 389-391.

Köke, A. J. A., Schouten, J. S. A. G., Lamerichs-Geelen, M. J. H., Lipsch, J. S. M., Waltje, E. M. H., Van Kleef, M., & Patijn, J. (2004). Pain reducing effect of three types of transcutaneous electrical nerve stimulation in patients with chronic pain: A randomized crossover trial. Pain, 108(1–2), 36–42.

Mulvey, M. R., Radford, H. E., Fawkner, H. J., Hirst, L., Neumann, V., & Johnson, M. I. (2010). Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults. Cochrane Database of Systematic Reviews (Online), 13(5), CD007264.

Tilak, M., Isaac, S. A., Fletcher, J., Vasanthan, L. T., Subbaiah, R. S., Babu, A., … Tharion, G. (2016). Mirror Therapy and Transcutaneous Electrical Nerve Stimulation for Management of Phantom Limb Pain in Amputees - A Single Blinded Randomized Controlled Trial. Physiotherapy Research International, 21(2), 109– 115. https://doi.org/10.1002/pri.1626

Nnoaham, KE. "Transcutaneous electrical nerve stimulation (TENS) for chronic pain." Cochrane Database of Systematic Reviews, 2008: CD003222.

Eldabe, S., Burger, K., Moser, H., Klase, D., Schu, S., Wahlstedt, A., … Subbaroyan, J. (2015). Dorsal root ganglion (DRG) stimulation in the treatment of phantom limb pain (PLP). Neuromodulation, 18(7), 610–616. https://doi.org/10.1111/ner.12338

Smits, H., Van Kleef, M., Holsheimer, J., & Joosten, E. (2013). Experimental Spinal Cord Stimulation and Neuropathic Pain : Mechanism of Action , Technical Aspects , and Effectiveness. Pain Practice, 13(2), 154–168. https://doi.org/10.1111/j.1533- 2500.2012.00579.x

McAuley, J., Van Gröningen, R., & Green, C. (2013). Spinal cord stimulation for intractable pain following limb amputation. Neuromodulation, 16(6), 530–535.

Viswanathan, A., Phan, P. C., & Burton, A. W. (2010). Use of spinal cord stimulation in the treatment of phantom limb pain: case series and review of the literature. Pain Practice : The Official Journal of World Institute of Pain, 10(5), 479–484.

Tintle, S. M., Baechler, M. F., Nanos, G. P., Forsberg, J. A., & Potter, B. K. (2012). Reoperations following combat-related upper-extremity amputations. Journal of Bone and Joint Surgery - Series A, 94(16), 1–6.

Zeng, Y., Wang, X., Guo, Y., He, L., & Ni, J. (2016). Coblation of Femoral and Sciatic Nerve for Stump Pain and Phantom Limb PaA Case Report. Pain Practice, 16(2), E35–E41. https://doi.org/10.1111/papr.12400

Farrell, S. M., Green, A., & Aziz, T. (2018). The current state of deep brain stimulation for chronic pain and its context in other forms of neuromodulation. Brain Sciences, 8(8). https://doi.org/10.3390/brainsci8080158

Daneshzand, M., Faezipour, M., & Barkana, B. D. (2018). Robust desynchronization of Parkinson’s disease pathological oscillations by frequency modulation of delayed feedback deep brain stimulation. PloS One, 13(11), e0207761. https://doi.org/10.1371/journal.pone.0207761

Smeets, A., Duits, A., Leentjens, A., Schruers, K., Kranen-Mastenbroek, V., Visser- Vandewalle, V., … Ackermans, L. (2018). Thalamic Deep Brain Stimulation for Refractory Tourette Syndrome: Clinical Evidence for Increasing Disbalance of Therapeutic Effects and Side Effects at Long-Term Follow Up. International Neuromodulation Society, 21, 197–202. https://doi.org/10.1111/ner.12556

Falowski, S. M. (2015). Deep Brain Stimulation for Chronic Pain. Current Pain and Headache Reports, 19(7), 27. https://doi.org/10.1007/s11916-015-0504-1

Abreu, V., Vaz, R., Rebelo, V., Rosas, M. J., Chamadoira, C., Gillies, M. J., … Pereira, E. A. C. (2017). Thalamic Deep Brain Stimulation for Neuropathic Pain: Efficacy at Three Years’ Follow-Up. Neuromodulation, 20(5), 504–513. https://doi.org/10.1111/ner.12620

Bittar, R. G., Otero, S., Carter, H., & Aziz, T. Z. (2005). Deep brain stimulation for phantom limb pain. Journal of Clinical Neuroscience, 12(4), 399–404. https://doi.org/10.1016/j.jocn.2004.07.013

Whyte, AS, and LJ Carroll. "A preliminary examination of the relationship between employment, pain and disability in an amputee population." Disabil Rehabil, 2002: 462-70.

Rudy, TE, SJ Lieber, JR Boston, LM Gourley, and E Baysal. "Psychosocial predictors of physical performance in disabled individuals with chronic pain." Clin J Path, 2003: 18-30.

Marshall, M, E Helmes, and AB Deathe. "A comparison of psychosocial functioning and personality in amputee and chronic pain populations." Clin J Pain, 1992: 351-7.

Ephraim, P. L., Wegener, S. T., MacKenzie, E. J., Dillingham, T. R., & Pezzin, L. E. (2005). Phantom pain, residual limb pain, and back pain in amputees: Results of a national survey. Archives of Physical Medicine and Rehabilitation, 86(10), 1910– 1919. https://doi.org/10.1016/j.apmr.2005.03.031

Mekhail, NA, A Aeschbach, and M Stanton-Hicks. "Cost benefit analysis of neurostimulation for chronic pain." Clin J Pain, 2004: 462-468.