Pain management after lower extremity amputation

Neurosurgery. 1987 Mar;20(3):496-500. doi: 10.1227/00006123-198703000-00027.

Abstract

Phantom pain may occur in up to 85% of patients after limb amputation. Although the pathophysiology of postamputation phantom pain is not well understood, it seems to be produced by a complex multifactorial interaction between the peripheral, sympathetic, and central nervous systems. The theoretical aspects of this are reviewed. Management of phantom limb pain may be both medical and surgical. Among the pharmacological agents proved effective against phantom pain are beta-blockers, tricyclic antidepressants, and anticonvulsants. Surgical management includes peripheral nerve stimulation, thermocontrolled coagulation of the spinal cord, spinal cord stimulation, transcutaneous nerve stimulation, and stereotactic deep brain stimulation.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Amputation Stumps / surgery
  • Amputation, Surgical*
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Electric Stimulation Therapy
  • Humans
  • Leg*
  • Narcotics / therapeutic use
  • Neurosurgery
  • Pain, Postoperative / etiology
  • Pain, Postoperative / physiopathology
  • Pain, Postoperative / therapy*
  • Phantom Limb / surgery

Substances

  • Adrenergic beta-Antagonists
  • Anticonvulsants
  • Antidepressive Agents, Tricyclic
  • Antipsychotic Agents
  • Narcotics