Effects of anesthesia on pain after lower-limb amputation

Incidence of phantom limb phenomena after lower limb amputations in a Singapore tertiary hospital

“…In contrast to our study population, Caucasian populations have fewer indications for amputation, and the usual indications are mainly neoplasm and trauma. (3)(4)(5)(6)(7)(8)(10)(11)(12) Third, our population was generally older, with a mean age of 62 years, which is in contrast to other studies that featured younger and middle-aged patients. (4)(5)(6)8) Age has been reported to correlate with PLP, with a study by Gallagher et al reporting that old age was positively related to the prevalence and severity of PLP.…”

“…A significant proportion of patients with PLP and SP are bothered by pain. (5,8,10,37) In our study, close to three-quarters of the patients who had moderateto-severe PLP and SP were not being followed up by medical practitioners. Most patients with moderate-to-severe PLP and SP were on analgesics.…”

“…and 93%. (3)(4)(5)(6)(8)(9)(10)(11)(12) According to the current understanding of neuropathic pain, peripherally originating impulses induce SP, whereas centrally arising nerve impulses induce phantom pain. In a clinical setting, SP can be modulated by peripheral interventions such as local anaesthesia of the neuroma or peripheral nerve, while phantom pain is not affected by such peripheral interventions.…”

“…In addition to the varying definitions of PLP and SP, selection and responder biases were found in many studies that recruited patients from rehabilitation clinics or via postal surveys. (3)(4)(5)(6)8,10,20) Most studies generally evaluated limited aspects of PLP and measured it at only one point in time. Prospective longitudinal surveys were plagued by high dropout rates, in part due to significant mortality after amputation.…”

“…(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) This wide variation in the reported incidences may be attributable to differences in the study populations, methodologies, definitions and cut-off values …”