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

Sin, Eliza I-Lin; Thong, Sze Ying; Poon, K.H.

doi:10.11622/smedj.2013028

Cited by 14 publications

(25 citation statements)

References 39 publications

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“…[ 4 ] However, another two recent study showed little higher incidence of SP of up to 39% and 61.5% [ Table 18 ]. [ 3 38 ] With the SP, there was higher occurrence of neuropathic features such as allodynia and hyperalgesia in our study, which was similar to previous studies. [ 14 15 18 21 ]…”

Section: Discussionsupporting

confidence: 91%

“…[ 2 ] However, in two recent studies done in Asian population in Singapore and African traumatic amputees had showed lower incidence of 25% and 32.5%, respectively. [ 3 4 ] There was PLP in 68% of the amputees (19 out of 28) in landmine accident survivors in Cambodia and Kurdistan. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 14 ] In an Asian study in Singapore, the PLP was constant in 8% and intermittent daily in 42% of patients. [ 3 ] Jensen et al . also found that PLP was constant in 47% of patients and intermittent daily in 35% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] The differences in the incidence may be due to the differences in the study design, population studied, methodology used, definitions used for PLP, different study periods and time of assessment, etc., Most of the study data are from the Caucasian populations, with only a few studies being from Asian and African population. [ 3 4 5 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 6 7 8 9 10 11 12 13 ] The phantom limb pain episodes vary in intensity, frequency, duration, location, character, etc. [ 3 14 15 16 17 18 19 ] It may be aggravated and relieved by a variety of factors. [ 15 16 17 19 20 21 22 23 ] A strong relationship between phantom limb pain and preoperative pain has been shown in a few studies.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study

Ahmed¹,

Bhatnagar²,

Mishra³

et al. 2017

Indian J Palliat Care

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Introduction: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.Methods: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.Results: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.Conclusion: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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study

Ahmed¹,

Bhatnagar²,

Mishra³

et al. 2017

Indian J Palliat Care

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Pharmacologic interventions for treating phantom limb pain

Alviar

Hale

Dungca³

2016

Cochrane Database of Systematic Reviews

138

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Since the last version of this review, we identified another study that added another form of medical therapy, BoNTs, specifically BoNT/A, to the list of pharmacologic interventions being reviewed for clinical efficacy in phantom limb pain. However, the results of this study did not substantially change the main conclusions. The short- and long-term effectiveness of BoNT/A, opioids, NMDA receptor antagonists, anticonvulsants, antidepressants, calcitonins, and local anaesthetics for clinically relevant outcomes including pain, function, mood, sleep, quality of life, treatment satisfaction, and adverse events remain unclear. Based on a small study, BoNT/A (versus lidocaine/methylprednisolone) does not decrease phantom limb pain. Morphine, gabapentin, and ketamine demonstrate favourable short-term analgesic efficacy compared with placebo. Memantine and amitriptyline may not be effective for PLP. However, results must be interpreted with caution, as they were based mostly on a small number of studies with limited sample sizes that varied considerably and also lacked long-term efficacy and safety outcomes. The direction of efficacy of calcitonin, local anaesthetics, and dextromethorphan needs further clarification. Overall, the efficacy evidence for the reviewed medications is thus far inconclusive. Larger and more rigorous randomised controlled trials are needed for us to reach more definitive conclusions about which medications would be useful for clinical practice.

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Prevalence of chronic pain after severe lower limb injury (SLLI): A systematic review and meta-analysis

Mahdi,

Stoner,

Wyatt

et al. 2024

Injury

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

Cited by 14 publications

References 39 publications

Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study

Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study

Pharmacologic interventions for treating phantom limb pain

Prevalence of chronic pain after severe lower limb injury (SLLI): A systematic review and meta-analysis

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