Phantom Limb Pain in Amputees During the First 12 Months Following Limb Amputation, After Preoperative Lumbar Epidural Blockade

Bach, Simon; Noreng, M.; Tjelldén, N. U.; Bridenbaugh, L. Donald

doi:10.1097/00132586-198902000-00028

Cited by 49 publications

(77 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Reports of pain memories in phantom limbs appear to be less common when there has been a discontinuity, or a pain-free interval, between the experience of pain and the amputation. This is consistent with the observation that relief of pre-amputation pain by continuous epidural block for 3 days prior to amputation decreases the incidence of phantom limb pain 6 months later (Bach et al 1988). Furthermore, if pain is experienced at or near the time of amputation, there is a higher probability that it will persist in the phantom limb (Jensen et al 1985;Katz and Melzack 1990).…”

Section: Pain In Phantom Limbs and Deafferented Structuressupporting

confidence: 91%

“…The clinical relevance of these findings is indicated by the observation that in human amputees .the incidence of phantom limb pain at 7 days and 6 months after amputation is significantly greater in patients whose pain is not treated by epidural block with bupivacaine and morphine prior to amputation surgery (Bach et al 1988). In contrast to the effect of increasing noxious inputs at the time of nerve injury, reducing or eliminating the afferent barrage induced by nerve section produces a dramatic reduction in autotomy.…”

Section: Deafferentation Pain In Animalsmentioning

confidence: 98%

See 1 more Smart Citation

Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence

Coderre

Katz

Vaccarino

et al. 1993

Pain

1,827

703

View full text Add to dashboard Cite

SummaryPeripheral tissue damage or nerve injury often leads to pathological pain processes, such as spontaneous pain, hyperalgesia and allodynia, that persist for years or decades after all possible tissue healing has occurred. Although peripheral neural mechanisms, such as nociceptor sensitization and neuroma formation, contribute to these pathological pain processes, recent evidence indicates that changes in central neural function may also playa significant role. In this review, we examine the clinical and experimental evidence which points to a contribution of central neural plasticity to the development of pathological pain. We also assess the physiological, biochemical, cellular and molecular mechanisms that underlie plasticity induced in the central nervous system (eNS) in response to noxious peripheral stimulation. Finally, we examine theories which have been proposed to explain how injury or noxious stimulation lead to alterations in eNS function which influence subsequent pain experience.

show abstract

Section: Pain In Phantom Limbs and Deafferented Structuressupporting

confidence: 91%

Section: Deafferentation Pain In Animalsmentioning

confidence: 98%

Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence

Coderre

Katz

Vaccarino

et al. 1993

Pain

1,827

703

View full text Add to dashboard Cite

show abstract

“…This suggests that under special circumstances (e.g. the presence before surgery of neuropathic pain or sensitization associated with nerve damage), changes in sensory processing can persist long-term with poorly blocked pre-or intraoperative nociception, as also suggested by the amputation studies of Bach, Noreng and Tjellden [26]. Further studies are needed to confirm this.…”

Section: Discussionmentioning

confidence: 92%

Surgical pain is followed not only by spinal sensitization but also by supraspinal antinociception

Wilder‐Smith¹,

Tassonyi²,

Senly³

et al. 1996

British Journal of Anaesthesia

View full text Add to dashboard Cite

SummaryNociception can produce segmental spinal sensitization or descending supraspinal antinociception. We assessed both types of sensory change after surgery during isoflurane-nitrous oxide anaesthesia with or without fentanyl before nociception. Patients undergoing back surgery received fentanyl 3 g kg 91 (n : 15) or placebo (n : 15) before anaesthesia in a prospective, randomized, blinded study. Sensation, pain detection and tolerance thresholds to electrical stimulation were measured before operation at the arm, incision and herniated disc dermatomes (HDD) and 1, 2, 4, 6, 24 h and 5 days after operation, together with pain scores and patient-controlled morphine consumption (duration 24 h). For segmental effects, thresholds were normalized to the thresholds at a distant dermatome (arm). Raw pain thresholds were increased after operation (fentanyl 9 placebo) and were maximal at 4 h (pain tolerance in HDD: fentanyl ;5.2 mA (;62.7 %), placebo, ;3.8 mA (;44.2 %); P : 0.05 vs baseline for both).Normalized sensation thresholds decreased for placebo only (HDD/4 h : placebo, 91.8 (944.8 %), P : 0.05; fentanyl, ;0.1 (;5.5 %) ns). All changes returned to baseline by 24 h except for the placebo group normalized HDD sensation (d5: placebo, 92.4 (959.7) %, P : 0.05; fentanyl 90.1 (95.5 %) ns). Pain scores and morphine consumption were similar. The study demonstrated both supraspinal analgesia and spinal sensitization after surgery. Fentanyl administration before operation augmented the former while decreasing the latter, and hence sensitization, especially if neuropathic, may particularly benefit from pre-emptive analgesia. (Br.

show abstract

“…Ainple clues are now available, from the pain literature (52)(53)(54)(55) and from the new field of psychoneuroendocrillology and iminunology (56,57), to suggest that patients with prolo~lged pain syndroines and other illnesses are not necessarily psychologically abnormal, although they may often be afflicted with depression and other co-morbidity (37). Newly identified feedback loops involving tissue inflammation, nociceptive sensory nerve stimulation, and central nervous system or endocrine amplification (58-62) have been identified in fibro~nyalgia patients.…”

Section: How Is the Severity Of Back Pain Determined?mentioning

confidence: 99%

Occupational back pain -- an unhelpful polemic

Frank¹,

Pulcins²,

Kerr³

et al. 1995

Scand J Work Environ Health

103

View full text Add to dashboard Cite

Phantom Limb Pain in Amputees During the First 12 Months Following Limb Amputation, After Preoperative Lumbar Epidural Blockade

Cited by 49 publications

References 0 publications

Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence

Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence

Surgical pain is followed not only by spinal sensitization but also by supraspinal antinociception

Occupational back pain -- an unhelpful polemic

Contact Info

Product

Resources

About