Continuous brachial plexus blockade in combination with the NMDA receptor antagonist memantine prevents phantom pain in acute traumatic upper limb amputees
| Autor: | Niels Birbaumer, C. Konrad, Katja Wiech, Hans Eberhard Schaller, Stephanie Töpfner, Martin Schmelz, Marcus Schley |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Pain Threshold Glutamic Acid Placebo Receptors N-Methyl-D-Aspartate Amputation Traumatic Double-Blind Method Memantine medicine Humans Brachial Plexus Ropivacaine Ketamine Anesthetics Local Pain Measurement business.industry Nociceptors Nerve Block Middle Aged medicine.disease Amides Pain Intractable Treatment Outcome Anesthesiology and Pain Medicine Phantom Limb Anesthesia Neuropathic pain Hyperalgesia Drug Therapy Combination Female medicine.symptom business Excitatory Amino Acid Antagonists Phantom pain Brachial plexus medicine.drug |
| Zdroj: | European Journal of Pain. 11:299-308 |
| ISSN: | 1090-3801 |
| DOI: | 10.1016/j.ejpain.2006.03.003 |
| Popis: | Background Hyperexcitability of N -methyl- d -aspartate acid (NMDA) receptors may play an important role in the development of phantom limb pain (PLP). Aim of the study To investigate whether early treatment with the NMDA antagonist memantine attenuates phantom pain memory formation in traumatic amputees. Methods In a randomized, double-blind, controlled trial 19 patients with acute traumatic amputation of the upper extremity were investigated. All patients received postoperative analgesia by continuous brachial plexus anesthesia (ropivacaine 0.375% 5 ml/h) for at least 7 days. In addition, the patients received either memantine (20–30 mg daily, n = 10) or placebo ( n = 9) for 4 weeks. Results Memantine treatment reduced the number of requested ropivacacine bolus injections during the first week and resulted in a significant decrease of PLP prevalence and intensity at 4 weeks and 6 months follow up, but not at 12 months follow up. Conclusions We conclude that memantine can reduce intensity of phantom limb pain and might also prevent the development of PLP. However, despite the very early begin of treatment; no long-term effect on established PLP was evident. |
| Databáze: | OpenAIRE |
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