1. Bloomquist, Thom MSN, CRNA, FAAPM

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Phantom limb pain can turn a traumatic experience into a lifetime of chronic pain, as mentioned in the interesting and well-written "Accidental Amputation" (Emergency, February). However, preliminary evidence shows that sustained multimodal pain management both before and after surgical amputation may decrease the incidence and severity of phantom limb pain. 1-3 Promising treatments include the use of such agents as N-methyl-D-aspartate receptor antagonists and anticonvulsants.


The most important thing is to ensure adequate pain management, preferably soon after the injury occurs. If a patient has lived with a mangled limb for a year before surgical amputation, alleviating postsurgical phantom limb pain is more difficult, especially if pain had not been attended to immediately after injury.




1. Ben Abraham R, et al. Dextromethorphan mitigates phantom pain in cancer amputees. Ann Surg Oncol 2003; 10(3):268-74. [Context Link]


2. Bach S, et al. Phantom limb pain in amputees during the first 12 months following limb amputation, after pre-operative lumbar epidural blockade. Pain 1988;33(3):297-301. [Context Link]


3. Katz J. Prevention of phantom limb pain by regional anaesthesia. Lancet 1997;349(9051):519-20. [Context Link]