Pain medicine case reports · 2024
Use of Peripheral Nerve Stimulation and Perineural Catheter to Treat Phantom Limb Pain in a Multiple Limb Amputee: Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Lehman Luke, Ahn Daniel, Curbelo Jacqueline, McClure Matthew
Аннотация
BACKGROUND: Limb loss is a debilitating condition affecting many Americans and approximately 80% go on to suffer phantom limb pain (PLP). Peripheral nerve stimulation (PNS) and perineural catheter (PC) placement are promising treatment options for PLP.
CASE REPORT: We present a 36-year-old man, who underwent right transhumeral and right transtibial amputations following a work-related accident. He developed significant PLP of both limbs. The right upper extremity PLP was treated first during the inpatient hospital course with a 5-day infusion of 0.5% ropivacaine via a PC. The right lower extremity PLP was later addressed in the outpatient setting with a diagnostic right sciatic/saphenous nerve block followed by a 60-day PNS lead placement, which provided > 50% pain relief from baseline. The patient continues to have > 50% pain relief in his RLE nearly 9 months after the initial procedure.
CONCLUSIONS: Our case adds to a growing body of evidence that supports the utility of PNS and PC. Future studies should explore whether early intervention with PNS could improve long-term outcomes. In addition, clinicians could consider the use of a PC for intractable PLP as an opioid-sparing strategy in the inpatient setting where close monitoring is feasible.
CASE REPORT: We present a 36-year-old man, who underwent right transhumeral and right transtibial amputations following a work-related accident. He developed significant PLP of both limbs. The right upper extremity PLP was treated first during the inpatient hospital course with a 5-day infusion of 0.5% ropivacaine via a PC. The right lower extremity PLP was later addressed in the outpatient setting with a diagnostic right sciatic/saphenous nerve block followed by a 60-day PNS lead placement, which provided > 50% pain relief from baseline. The patient continues to have > 50% pain relief in his RLE nearly 9 months after the initial procedure.
CONCLUSIONS: Our case adds to a growing body of evidence that supports the utility of PNS and PC. Future studies should explore whether early intervention with PNS could improve long-term outcomes. In addition, clinicians could consider the use of a PC for intractable PLP as an opioid-sparing strategy in the inpatient setting where close monitoring is feasible.