Licina Lauren, Hamsher Carlyle, Lautenschager Karl, Dhanjal Sandeep, Williams Necia, Spevak Christopher
Department of Anesthesiology, Georgetown University School of Medicine, 4000 Reservoir Road NW, Washington, DC 20007, USA.
Mil Med. 2013 Jul;178(7):e858-61. doi: 10.7205/MILMED-D-12-00310.
Phantom limb pain is a common consequence of limb amputation and is prevalent among the service members sustaining traumatic battlefield limb injuries during the conflicts in Iraq and Afghanistan. Current treatment to relieve phantom limb pain consists of physical, behavioral, and medical modalities including opioids and adjunct medications. Treatment failure resulting in persistent pain and disability may result. This case series describes four previously healthy service members who developed phantom limb pain following traumatic amputation successfully treated with buprenorphine/naloxone after failing traditional treatment. This is the first reported case series of patients expressing improved pain control with decreased frequency of phantom limb pain with the use of buprenorphine/naloxone instead of traditional opioid agonists.
幻肢痛是肢体截肢的常见后果，在伊拉克和阿富汗冲突期间遭受战场创伤性肢体损伤的军人中很普遍。目前缓解幻肢痛的治疗方法包括物理、行为和药物治疗，其中药物治疗包括使用阿片类药物和辅助药物。可能会出现治疗失败，导致持续性疼痛和残疾。本病例系列描述了四名此前健康的军人，他们在传统治疗失败后，使用丁丙诺啡/纳洛酮成功治疗了创伤性截肢后出现的幻肢痛。这是首次报道的使用丁丙诺啡/纳洛酮而非传统阿片类激动剂，患者疼痛控制得到改善且幻肢痛发作频率降低的病例系列。
