Pain management in lower limb major amputation

Abstract

One of the risk factors associated with a higher incidence of chronic phantom limb pain in amputational surgery is pain pre-surgery. The aim of this study was to follow up patients who received opioids as analgesia before surgery (Group A) or after amputation surgery (Group B) over a 6 month period following surgery. The effect of these interventions on the number of days in hospital when compared to patients receiving analgesia after the amputation was also determined. Thirty patients undergoing elective major lower limb amputation over a 6 month period were eligible for analysis and fitted the inclusion criteria. Twelve patients were allocated to Group A: 22.2% were on pethidine, 66.6% on morphine and 11.2% received codeine. Group B had eighteen patients. Post-operative pain was determined using the Visual Analogue Scale on day 1, 3 and 7, month 3 and 6 post-operativally. In addition the patient’s perception of stump pain and phantom limb pain was also assessed. [excerpt]