Optimized Perioperative Analgesia Reduces the Prevalence and the Intensity of Phantom Pain in Lower Limb Amputation
Phantom Limb Pain
About this trial
This is an interventional prevention trial for Phantom Limb Pain focused on measuring phantom, amputation, analgesia, pain, preemptive, perioperative, lower limb amputation, intensity of phantom limb pain, preemptive analgesia reduces phantom pain, perioperative analgesia reduces phantom pain, Severe Phantom Limb Pain (VAS>70 mm), resistant to medical treatment one week before amputation
Eligibility Criteria
Inclusion Criteria:
- Age >18, Visual Analog. Scale (VAS) pain score >70mm which was frequent or continuous one week before scheduled major (above or below knee) amputation, and patient consent.
Exclusion Criteria:
- No written patient consent
- Age < 18 years
- Age > 82 years
- Antiplatelet medication
- Mental status not acceptable
- Exclusion criteria were age >85
- Emergency amputation
- Ipsilateral re-amputation
- Foot or toe amputation
- Inability to complete a detailed pain questionnaire
- History of chronic pain or substance abuse
- Active psychiatric disease requiring treatment
- Any contraindication to epidural catheter placement (anticoagulation, anti-platelet medications, previous lumbar spine surgery).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Placebo Comparator
1
2
3
4
5
perioperative epidural analgesia
Iv PCA Fentanyl preoperative, Epidural analgesia postoperative
perioperative IV PCA Fentanyl, epidural anesthesia
perioperative IV PCA Fentanyl general anesthesia
IV PCA with saline 0.9% and sc saline 0.9%in the L3-L4 area. IM meperidine, po codeine/acetaminophen, IV acetaminophen and IV parecoxib