Anghelescu Doralina L, Kelly Cassandra N, Steen Brenda D, Wu Jianrong, Wu Huiyun, DeFeo Brian M, Scobey Kristin, Burgoyne Laura
Department of Pediatric Medicine, Division of Anesthesiology, Director, Pain Management Service, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Rehabil Oncol. 2016 Jul;34(3):104-110.
BACKGROUND AND PURPOSE/OBJECTIVE: Mirror therapy has not been reported for phantom limb pain (PLP) in pediatric oncology. Our aims are to describe the incidence and duration of PLP post-amputation, the duration of follow-up, pain scores and pain medications, and the differences between a group that received mirror therapy (MT) in addition to the standard treatment and a group that received only the standard treatment (non-MT).
A retrospective review of patients' medical records from June 2009 to March 2015 was completed. The demographic characteristics, diagnoses and types of surgery were collected. The incidence and duration of PLP, duration of pain service follow-up, pain medications and pain scores were collected and analyzed using the Wilcoxon rank sum test.
Of 21 patients who underwent amputations (median age 13 years, range, 8-24 years), most common primary diagnosis osteosarcoma), 18 (85.7%) experienced PLP; 38.9% of them experienced PLP at 1 year post-amputation (11.1% of the MT group and 66.7% of the non-MT group). The MT group and non-MT groups experienced PLP for a mean (± SD) of 246 (± 200) days, and 541 (± 363) days, respectively (p=0.08). The mean (SD) opioid doses (mg/kg/day) in the MT and non-MT groups were 0.81 (± 0.99) and 0.33 (± 0.31), respectively; the mean (SD) gabapentin doses (mg/kg/day) were 40.1 (± 21) for the MT group and 30.5 (± 11.5) for the non-MT group.
MT in children with cancer-related amputations is associated with lower incidence of PLP at 1 year and shorter duration of PLP.
儿童肿瘤患者截肢后幻肢痛(PLP)的镜像疗法尚未见报道。我们的目的是描述截肢后PLP的发生率和持续时间、随访时间、疼痛评分及止痛药物使用情况,以及比较除接受标准治疗外还接受镜像疗法(MT)的组与仅接受标准治疗(非MT组)之间的差异。
对2009年6月至2015年3月患者的病历进行回顾性分析。收集人口统计学特征、诊断及手术类型。收集PLP的发生率和持续时间、疼痛门诊随访时间、止痛药物及疼痛评分,并采用Wilcoxon秩和检验进行分析。
21例接受截肢手术的患者(中位年龄13岁,范围8 - 24岁),最常见的原发诊断为骨肉瘤,18例(85.7%)发生PLP;其中38.9%在截肢后1年出现PLP(MT组为11.1%,非MT组为66.7%)。MT组和非MT组PLP的平均(±标准差)持续时间分别为246(±200)天和541(±363)天(p = 0.08)。MT组和非MT组平均(标准差)阿片类药物剂量(mg/kg/天)分别为0.81(±0.99)和0.33(±0.31);MT组和非MT组加巴喷丁平均(标准差)剂量(mg/kg/天)分别为40.1(±21)和30.5(±11.5)。
癌症相关截肢儿童接受MT治疗与1年时较低的PLP发生率及较短的PLP持续时间相关。