Mishra Seema, Bhatnagar Sushma, Gupta Deepak, Diwedi Alok
Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Am J Hosp Palliat Care. 2007;24(6):455-62. doi: 10.1177/1049909107304558. Epub 2007 Sep 21.
Antidepressants and anticonvulsants are currently considered to be the drug treatment of choice for neuropathic pain. Opioids are effective in relieving neuropathic pain, including phantom pain in the early postoperative course. The present study of 42 cancer patients with limb amputation was conducted to determine the incidence of phantom limb pain and phantom sensation and to test the utility of the World Health Organization 3-step analgesic ladder in phantom limb pain management. Patients were monitored monthly for the first 2 months postoperatively and every 2 months thereafter for 2 years. The World Health Organization analgesic ladder was followed for pain management. The patients complaining of phantom sensation, phantom pain, and stump pain decreased from 69%, 60%, and 31%, respectively, at 1 month to 32%, 32%, and 5%, at the end of 2 years with the addition of opioids. The World Health Organization analgesic ladder played significant role in phantom limb pain management.
目前，抗抑郁药和抗惊厥药被认为是治疗神经性疼痛的首选药物。阿片类药物在缓解神经性疼痛方面有效，包括术后早期的幻肢痛。本研究对42例肢体截肢的癌症患者进行，以确定幻肢痛和幻肢感觉的发生率，并测试世界卫生组织三阶梯镇痛法在幻肢痛管理中的效用。术后前2个月每月对患者进行监测，此后2年每2个月监测一次。疼痛管理遵循世界卫生组织镇痛阶梯。随着阿片类药物的加入，抱怨有幻肢感觉、幻肢痛和残端痛的患者分别从术后1个月时的69%、60%和31%降至2年结束时的32%、32%和5%。世界卫生组织镇痛阶梯在幻肢痛管理中发挥了重要作用。
