Is post amputation pain sympathetically maintained?

Harden, R. Norman; Newman, D.; Daschbach, P.; Ranjbaran, Ziba; Lauzon, Jean-François; Houle, Timothy T.; Addison, Robert G.

doi:10.1016/j.jpain.2005.01.091

Cited by 3 publications

(2 citation statements)

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“…The Efferent Theory of PLP hypothesizes that sympathetic dysregulation serves as a mechanism that stimulates and maintains PLP [154,155]. A large subset of individuals exhibit significant dysfunction and asymmetry of sympathetic tone in the residual limb after amputation [156], suggesting that a distinct component of PLP may be sympathetically maintained pain [157–161]. Electrical and mechanical stimulation of the para‐vertebral sympathetic chain causes intense pain in the phantom limb [38].…”

Section: Efferent Sympathetic Mechanism As a Target For Treatmentmentioning

confidence: 99%

Phantom Limb Pain: A Systematic Neuroanatomical-Based Review of Pharmacologic Treatment

et al. 2013

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Currently, the best evidence (level 2) exists for the use of IV ketamine and IV morphine for the short-term perioperative treatment of PLP and PO morphine for an intermediate to long-term treatment effect (8 weeks to 1 year). Level 2 evidence is mixed for the efficacy of perioperative epidural anesthesia with morphine and bupivacaine for short to long-term pain relief (perioperatively up to 1 year) as well as for the use of gabapentin for pain relief of intermediate duration (6 weeks).

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Section: Efferent Sympathetic Mechanism As a Target For Treatmentmentioning

confidence: 99%

Phantom Limb Pain: A Systematic Neuroanatomical-Based Review of Pharmacologic Treatment

et al. 2013

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“…Sympathetically maintained pain mechanisms believed to participate in driving CRPS has also been suggested to play a role in PAP . The presumption is that after peripheral nerve injury, sympathetic neurons undergo “sprouting.” The activation of sympathetic postganglionic axons stimulates the nearby primary afferent sensory neurons . The increased sympathetic activity raises circulating epinephrine concentration during emotional distress thought to cause pain amplification and exacerbation .…”

Section: Discussionmentioning

confidence: 99%