Post-op Pain Unrelated to Phantom Limb Pain Development

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Although pain management before amputation is important, the efficacy of pre-emptive analgesia for prevention of phantom limb pain  is controversial. A study published online January 2 in the Journal of Anesthesia aimed to determine the factors associated with perioperative phantom limb pain.

Researchers in the department of anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan, retrospectively reviewed the medical records of patients receiving amputation surgery at its hospital between April 1, 2013, and October 31, 2017. To determine which pre-operative factors could affect the development of phantom limb pain, researchers performed univariate analysis to find candidate factors, and then did multivariate regression analysis.

Incidence of phantom limb pain was 50 percent (22/44), and there was no recorded difference between the groups in types of anesthesia and post-operative pain levels. The multivariate logistic regression that included possible confounders suggested that diabetes mellitus and uncontrollable pre-operative pain with non-steroidal anti-inflammatory drugs (NSAIDs) were independently associated with the development of phantom limb pain.

The study found that the types of anesthesia and the degree of post-operative pain were not related to the development of phantom limb pain. The data suggested that insufficient pre-operative pain with NSAIDs and diabetes mellitus would have an impact on the development of phantom limb pain, according to the study's authors.