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Prevention
By Mayo Clinic staffBecause the risk of developing phantom pain is higher for people who have experienced pain in the limb before amputation, some doctors recommend regional anesthesia (spinal or epidural) in the few hours or days leading up to amputation. This may reduce pain immediately following surgery and reduce the risk of lasting phantom limb pain.
Two drugs have shown promise in preventing phantom pain:
- Calcitonin (Miacalcin). Researchers aren't sure why calcitonin — a hormone produced by the body that slows the rate at which your body breaks down bone — provides pain relief. You may receive this drug directly into a vein (intravenously) during the week after amputation. Possible side effects include nausea, vomiting and allergic reactions, including rashes, abdominal pain and swelling.
- Ketamine (Ketalar). This anesthetic drug is sometimes given after surgery to help prevent phantom pain. Its side effects can include sedation, hallucinations and delirium.
References
- Pain: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm. Accessed Aug. 11, 2011.
- Weeks SR, et al. Phantom limb pain: Theories and therapies. The Neurologist. 2010;16:277.
- Rothgangel AS, et al. The clinical aspects of mirror therapy in rehabilitation: A systematic review of the literature. International Journal of Rehabilitation Research. 2011;34:1.
- Portenoy RK, et al. Overview of cancer pain syndromes. http://www.uptodate.com/home/index.html. Accessed Aug. 1, 2011.
- Phantom pain: An update. Amputee Coalition. http://www.amputee-coalition.org/communicator/vol3no1pg3.html. Accessed Aug. 11, 2011.
- McNutt S. New paths in phantom limb pain treatment. Amputee Coalition of America. http://www.amputee-coalition.org/inmotion/mar_apr_07/phantom_treatment.html. Accessed Aug. 11, 2011.
- Casale R, et al. Phantom limb related phenomena and their rehabilitation after lower limb amputation. European Journal of Physical and Rehabilitation Medicine. 2009;45:559.
- Viswanathan A, et al. Use of spinal cord stimulation in the treatment of phantom limb pain: Case series and review of the literature. Pain Practice. 2010;10:479.
- Ramchandran K, et al. Fast facts and concepts: Phantom limb pain #212. Journal of Palliative Medicine. 2010;13:1285.
- Treatment options: A guide for people living with pain. American Pain Foundation. http://www.painfoundation.org/learn/publications/treatment-options.html. Accessed Aug. 14, 2011.
- Acupuncture for pain. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm. Accessed Aug. 11, 2011.
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