Ahmed Arif, Bhatnagar Sushma, Mishra Seema, Khurana Deepa, Joshi Saurabh, Ahmad Syed Mehmood
Department of Anesthesia, Pain and Palliative Care, Dr. B.R.A. Institute Rotary Cancer Hospital, All Institute of Medical Sciences, New Delhi, India.
Indian J Palliat Care. 2017 Jan-Mar;23(1):24-35. doi: 10.4103/0973-1075.197944.
The phantom limb pain (PLP) and phantom limb sensation (PLS) are very common among amputated cancer patients, and they lead to considerable morbidity. In spite of this, there is a lack of epidemiological data of this phenomenon among the Asian population. This study was done to provide the data from Indian population.
The prevalence of PLP, stump pain (SP), and PLS was prospectively analyzed from the amputated cancer patients over a period of 2 years in Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi. The risk factors and the impact of phantom phenomenon on patients were also noted.
The prevalence of PLP was 41% at 3 and 12 months and 45.3% at 6 months, whereas that of SP and PLS was 14.4% and 71.2% at 3 months, 18.75% and 37.1% at 6 months, 15.8% and 32.4% at 12 months, respectively. There was higher prevalence of PLP and PLS among the patients with history of preamputation pain, smoking with proximal level of amputation, receiving general anesthesia, receiving intravenous (IV) opioid postoperative analgesia, and developing neuroma or infection.
The prevalence of PLP and PLS was higher among the cancer amputees as compared to SP, and a few risk factors responsible for their higher prevalence were found in our study. The PLP and PLS lead to considerable morbidity in terms of sleep disturbance and depression.
幻肢痛(PLP)和幻肢感觉(PLS)在截肢癌症患者中非常常见,并会导致相当高的发病率。尽管如此,亚洲人群中关于这一现象的流行病学数据却很缺乏。本研究旨在提供来自印度人群的数据。
在新德里全印度医学科学研究所B.R.A. 研究所扶轮癌症医院,对截肢癌症患者在两年时间内进行前瞻性分析,以确定PLP、残端痛(SP)和PLS的患病率。同时还记录了危险因素以及幻肢现象对患者的影响。
PLP在3个月和12个月时的患病率为41%,6个月时为45.3%;而SP和PLS在3个月时的患病率分别为14.4%和71.2%,6个月时为18.75%和37.1%,12个月时为15.8%和32.4%。有截肢前疼痛史、吸烟且截肢部位靠近近端、接受全身麻醉、接受静脉(IV)阿片类药物术后镇痛以及发生神经瘤或感染的患者中,PLP和PLS的患病率更高。
与SP相比,癌症截肢患者中PLP和PLS的患病率更高,并且在我们的研究中发现了一些导致其患病率较高的危险因素。PLP和PLS在睡眠障碍和抑郁方面会导致相当高的发病率。