Features of opioid analgesia s in patients with phantom limb pain after amputation due to gunshot wounds

Abstract

Background. Since the beginning of the large-scale war on the territory of Ukraine, the incidence of limb injuries has reached 40 %: 15 % of them are upper limb injuries, 25 % are lower limb injuries, and the proportion of patients who have lost limbs due to trauma has increased significantly. In these patients, phantom pain occurs in more than 60 % of cases. Such pain is extremely difficult to treat with standard approaches. Usually, the prescription of opioid analgesics is required, but there is no data on their effectiveness in the comprehensive therapy of phantom pain, which appears as a result of limb amputation and is one of the most difficult clinical problems today. Materials and methods. Our study involved 57 patients. The diagnosis of phantom pain was made based on the clinical picture and patient description. The severity of pain was studied using the visual analog scale. To determine the neuropathic component of pain, Douleur Neuropathique 4 questions were used. The distribution of quantitative indicators for normality was checked with the Shapiro-Wilk test and Student’s test. Results. According to the visual analog scale data, no significant statistical difference was found between group 1 and 2 (p > 0.05). The data of Douleur Neuropathique 4 questions indicate that group 1 has statistically better results than group 2 (p < 0.05). Conclusions. The results of pain relief in patients with phantom limb pain after amputation due to gunshot wounds in comprehensive therapy shows a better result than tramadol.

Keywords

• pain management
• treatment stages
• phantom pain
• gunshot wounds
• mine blast injuries
• opioid analgesics
• pain relief