Use of somatosensory memory correction for the prevention of phantom pain after lower limb amputation
Background. Phantom pain syndrome (PPS) is one of the leading syndromes that complicates the postoperative period after limb amputation. Literature data indicate that it occurs in 30–35 % of the total number of patients with amputation; however, the causes are not exactly established. An important factor for PPS development is the constant pain impulses in the pre- and intraoperative period which, in turn, lead to the formation of a persistent pain in the postoperative period according to the concept of somatosensory memory. Aim: to determine the effectiveness of epidural catheter anesthesia for the prevention of phantom pain after lower extremity amputation. Materials and methods. An analysis was performed of the data in 38 patients who were on in-patient treatment at the Luhansk Regional Clinical Hospital in 2009–2014 and underwent lower limb amputation at different levels. All patients were divided into 2 groups (19 patients each), depending on the type of anesthesia. The control group consisted of patients who received general anesthesia. The main group of patients received treatment in accordance with the concept of somatosensory memory. Results. The results of this study prove that the treatment strategy which includes the concept of somatosensory memory allows reducing significantly the incidence, severity and duration of PPS in patients after lower limb amputation. Conclusions. The method of epidural catheter anesthesia in pre- and intraoperative periods can be recommended for the prevention of phantom pain syndrome after lower limb amputation and requires wider use in Ukraine.
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