Pharmacological interventions for phantom limb pain

• Published in: Chinese medical journal 2013-02, Vol.126 (3), p.542-549
• Main Authors: Fang, Jun, Lian, Yan-hong, Xie, Kang-jie, Cai, Shu-nü
• Format: Article
• Language: English
• Subjects: Analgesics - therapeutic use; Analgesics, Opioid - therapeutic use; Anticonvulsants - therapeutic use; Antidepressive Agents - therapeutic use; Humans; MEDLINE; Phantom Limb - drug therapy; Tramadol - therapeutic use; β-肾上腺素能; 临床应用; 受体拮抗剂; 天门冬氨酸; 干预措施; 药物管理; 非甾体类抗炎药
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.20121599

Objective To review the mechanisms and current clinical application of pharmacological interventions for phantom limb pain. Data sources Both Chinese and English language literatures were searched using MEDLINE （1982-2011）, Pubmed （1982-2011） and the Index of Chinese Language Literature （1982-2011 ）. Study selection Data from published articles about pharmacological management of phantom limb pain in recent domestic and foreign literature were selected. Data extraction Data were mainly extracted from 96 articles which are listed in the reference section of this review. Results By reviewing the mechanisms and current clinical application of pharmacological interventions for phantom limb pain, including anticonvulsants, antidepressants, local anaesthetics, N-methyI-D-aspartate receptor antagonists, non-steroidal anti-inflammatory drugs, tramadol, opioids, calcitonin, capsaicin, beta-adrenergic blockers, clonidine, muscle relaxants, and emerging drugs, we examined the efficacy and safety of these medications, outlined the limitations and future directions. Conclusions Although there is lack of evidence-based consensus guidelines for the pharmacological management of phantom limb pain, we recommend tricyclic antidepressants, gabapentin, tramadol, opioids, local anaesthetics and N-methyI-D-aspartate receptor antagonists as the rational options for the treatment of phantom limb pain.