Treatment of phantom limb pain by cryo analgesia in the amputated nerve vessel trunk

摘要

In a prospective amputees study in patients after lower limb amputation with peripheral vascular disease, Richardson et al. (2006) found after 6 months phantom limb pain in 78.8% of the survived patients. Several theories exist regarding the pa-thophysiology of phantom limb pain, which are broadly divided into those based on central causes, spinal causes or peripheral causes. Although the use of various nerve blocks, regional blocks, intrathecal/epidural opioids, sympathetic blocks and electrical nerve stimulation has been reported, our treatment focuses on a peripheral cause of phantom limb pain. The final treatment is cryoanalgesia at this location, i.e. 3 min of freezing, 2 min defrosting, and 3 min freezing at minus 60°C. Evaluation of the 5 patients treated during the last 10 years yielded the following results. Three patients had excellent results (100%, 95% and 90% decrease of complaints, respectively), one patient had an acceptable result (40% decrease), and one patient had a 20% decrease of complaints.