Long-term high-dose oral morphine in phantom limb pain with no addiction risk

Purpose: Presentation of the latest discoveries and progress in treating phantom limb pain (PLP). Views: A variety of strategies are used in PLP therapy. Among non-pharmacological methods the best results are obtained by mirror therapy, which creates the illusion of an existing healthy limb. Other advantages of this therapy are its non-invasive character and low cost. Other methods of which much is expected are: graded motor imagery (GMI), hypnosis, electromagnetically shielding limb liner, and virtual reality. Many drugs are taken into consideration as potential agents that may lower the pain, including nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, opioids, antidepressants, anticonvulsants, etc. Although nowadays nonsteroidal anti-inflammatory drugs are most commonly used, researches are mostly focused on gabapentin, which shows efficacy. From a psychological point of view, it is important to remember that following amputation patients experience grief for the loss of the prior body image. Many factors pre-dating surgery contribute to difficulties in undergoing such a process, as well as a feeling of increasing pain, so it is worth including teams of psychologists who take care of patients before and after amputation. Conclusions: Current attempts to treat PLP, show differing degrees of efficacy among patients, so it is therefore impossible to set a consistent treatment scheme. For this reason alone, it is recommended to select appropriate therapy on an individual basis. Knowing the precise pathophysiology of an individual's pain could be helpful in improving the treatment methods. The character of pain of this sort suggests the necessity of engaging specialists from different fields in order to treat the condition.

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“…Any attempt to withdraw morphine caused renewal of the pain. The patient did not show any signs of toxicity or opioid dependence [25].…”

Section: Analgesicsmentioning

confidence: 83%

Phantom outside the opera – a review of current findings on treating phantom pain

Oleksak¹,

Psiuk²,

Maliszewska³

et al. 2020

ppn

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“…Morphine is a strong analgesic which has been used for releasing acute or chronic pain for a long time [10]. Previous studies have reported that the dose of morphine is determined based on its effect and there is no defined ceiling dosage [11]. Here, we report a case of systemic multiple EHE that underwent prolonged ultrahigh doses of intravenous morphine without significant signs of addiction.…”

Section: Introductionmentioning

confidence: 89%

Application of Ultrahigh Doses of Morphine in Systemic Multiple Epithelioid Hemangioendothelioma without Addiction: A Case Report

Liu¹,

Ma²,

Ning³

et al. 2019

CRCM

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Morphine is a potent opioid which is commonly used for relieving cancer pain with strong analgesic properties. Epithelioid hemangioendothelioma (EHE), a rare vascular tumor that can cause severe chronic pain, is usually diagnosed in a surgical biopsy. We describe ultrahigh doses of morphine used in a case of a 17-year-old male who suffered from severe chest pain with systemic multiple EHE. The total dosage of morphine was as high as 92,530 mg given within 164 days. However, we observed no indications that the patient was addicted.

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