Treating Intractable Post-Amputation Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks

2014 ◽  
Author(s):  
Brian M. Ilfeld ◽  
Anya Morgan
Keyword(s):  
Peripheral Nerve ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

scholarly journals Treating Intractable Phantom Limb Pain with Ambulatory Continuous Peripheral Nerve Blocks: A Pilot Study

Pain Medicine ◽  
2013 ◽  
Vol 14 (6) ◽  
pp. 935-942 ◽  
Author(s):  
Brian M. Ilfeld ◽  
Tobias Moeller-Bertram ◽  
Steven R. Hanling ◽  
Kyle Tokarz ◽  
Edward R. Mariano ◽  
...  
Keyword(s):  
Pilot Study ◽  
Peripheral Nerve ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

scholarly journals Ambulatory continuous peripheral nerve blocks to treat post-amputation phantom limb pain a multicenter, randomized, quadruple-masked, placebo-controlled clinical trial

Pain ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Brian M. Ilfeld ◽  
Bahareh Khatibi ◽  
Kamal Maheshwari ◽  
Sarah J. Madison ◽  
Wael Ali Sakr Esa ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Peripheral Nerve ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Controlled Clinical Trial ◽  
Limb Pain ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

scholarly journals Development of Phantom Limb Pain after Femoral Nerve Block

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Sadiah Siddiqui ◽  
Anthony N. Sifonios ◽  
Vanny Le ◽  
Marc E. Martinez ◽  
Jean D. Eloy ◽  
...  
Keyword(s):  
Nerve Block ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Subsequent Development ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Prevention And Treatment

Historically, phantom limb pain (PLP) develops in 50–80% of amputees and may arise within days following an amputation for reasons presently not well understood. Our case involves a 29-year-old male with previous surgical amputation who develops PLP after the performance of a femoral nerve block. Although there have been documented cases of reactivation of PLP in amputees after neuraxial technique, there have been no reported events associated with femoral nerve blockade. We base our discussion on the theory that symptoms of phantom limb pain are of neuropathic origin and attempt to elaborate the link between regional anesthesia and PLP. Further investigation and understanding of PLP itself will hopefully uncover a relationship between peripheral nerve blocks targeting an affected limb and the subsequent development of this phenomenon, allowing physicians to take appropriate steps in prevention and treatment.

scholarly journals Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Pain Following Amputation

2019 ◽  
Vol 184 (7-8) ◽  
pp. e267-e274 ◽  
Author(s):  
Steven P Cohen ◽  
Christopher A Gilmore ◽  
Richard L Rauck ◽  
Denise D Lester ◽  
Robert J Trainer ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Military Service ◽  
Phantom Limb Pain ◽  
Peripheral Nerve Stimulation ◽  
Service Members ◽  
Phantom Limb ◽  
Limb Pain ◽  
Military Service Members

Abstract Introduction Chronic pain and reduced function are significant problems for Military Service members and Veterans following amputation. Peripheral nerve stimulation (PNS) is a promising therapy, but PNS systems have traditionally been limited by invasiveness and complications. Recently, a novel percutaneous PNS system was developed to reduce the risk of complications and enable delivery of stimulation without surgery. Materials and Methods Percutaneous PNS was evaluated to determine if stimulation provides relief from residual and phantom limb pain following lower-extremity amputation. PNS leads were implanted percutaneously to deliver stimulation to the femoral and/or sciatic nerves. Patients received stimulation for up to 60 days followed by withdrawal of the leads. Results A review of recent studies and clinical reports found that a majority of patients (18/24, 75%) reported substantial (≥50%) clinically relevant relief of chronic post-amputation pain following up to 60 days of percutaneous PNS. Reductions in pain were frequently associated with reductions in disability and pain interference. Conclusions Percutaneous PNS can durably reduce pain, thereby enabling improvements in quality of life, function, and rehabilitation in individuals with residual or phantom limb pain following amputation. Percutaneous PNS may have additional benefit for Military Service members and Veterans with post-surgical or post-traumatic pain.

scholarly journals Effectiveness of Perineural Dexmedetomidine and Ropivacaine on Preventing Phantom Limb Pain in Patients Undergoing Femoral Supracondylar Amputation

2020 ◽  
pp. 11-17
Author(s):  
MD. Ramírez Jaime ◽  
MD. Estrada Sara ◽  
MD. Martínez Raquel
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Dorsal Root ◽  
Peripheral Nerve Block ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain ◽  
Treatment And Prevention ◽  
Local Anesthetic Infiltration

Background: Phantom limb pain is a frequent complication after limb amputation, its pathophysiology is complex and includes changes in the peripheral nerve, dorsal root ganglia, spinal cord, cerebral cortex, and thalamus. At this time, there is not an effective drug for treatment and prevention of phantom limb pain. Perineural local anesthetic infiltration has obtained different results in the prevention of phantom limb pain, so we propose to combine an α2 agonist in peripheral nerve block to assess its effectiveness in preventing postoperative pain.

scholarly journals The Role of Continuous Peripheral Nerve Blocks

2012 ◽  
Vol 2012 ◽  
pp. 1-20 ◽  
Author(s):  
José Aguirre ◽  
Alicia Del Moral ◽  
Irina Cobo ◽  
Alain Borgeat ◽  
Stephan Blumenthal
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Sleep Disturbances ◽  
Phantom Limb Pain ◽  
Pain Syndrome ◽  
Joint Inflammation ◽  
Catheter Removal ◽  
Phantom Limb ◽  
Ambulatory Setting ◽  
Nerve Blocks

A continuous peripheral nerve block (cPNB) is provided in the hospital and ambulatory setting. The most common use of CPNBs is in the peri- and postoperative period but different indications have been described like the treatment of chronic pain such as cancer-induced pain, complex regional pain syndrome or phantom limb pain. The documented benefits strongly depend on the analgesia quality and include decreasing baseline/dynamic pain, reducing additional analgesic requirements, decrease of postoperative joint inflammation and inflammatory markers, sleep disturbances and opioid-related side effects, increase of patient satisfaction and ambulation/functioning improvement, an accelerated resumption of passive joint range-of-motion, reducing time until discharge readiness, decrease in blood loss/blood transfusions, potential reduction of the incidence of postsurgical chronic pain and reduction of costs. Evidence deriving from randomized controlled trials suggests that in some situations there are also prolonged benefits of regional anesthesia after catheter removal in addition to the immediate postoperative effects. Unfortunately, there are only few data demonstrating benefits after catheter removal and the evidence of medium- or long-term improvements in health-related quality of life measures is still lacking. This review will give an overview of the advantages and adverse effects of cPNBs.

Preoperative Modeling Intervention for Phantom Limb Pain

2006 ◽  
Author(s):  
Cheree L. Nichole ◽  
William G. Johnson
Keyword(s):  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain

Cortical reorganization in phantom limb pain changes after regional anesthesia of the amputated limb

1996 ◽  
Author(s):  
P. Montoya ◽  
N. Birbaumer ◽  
W. Lutzenberger ◽  
H. Flor ◽  
W. Grodd ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Limb Pain
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