Affiliations: [a] Physical Therapy and Rehabilitation Unit, University of Bologna - IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy
| [b] Physical Medicine and Rehabilitation Unit –IRCCS –Istituto Ortopedico Rizzoli, Bologna, BO, Italy
| [c] Anesthesia and Post-Operative Intensive Care, IRCCS-Istituto ortopedico Rizzoli, Bologna, BO, Italy
| [d] Fondazione Santa Lucia, Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy
Correspondence:
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Correspondence to: Maria Grazia Benedetti, Physical Therapy and Rehabilitation Unit University of Bologna - IRCCS-Istituto Ortopedico Rizzoli Via Pupilli 1, 40136 Bologna, Italy. Tel.: +390516366236; Fax: +39051 332392; E-mail: benedetti@ior.it.
Abstract: BACKGROUND:Chronic pain is common in patients who undergo lower limb amputation. The use of epidural or perineural catheters seems to reduce acute pain after surgery but their effects in a longer follow up are unknown. OBJECTIVE:To evaluate the long-term prevalence of phantom limb sensation (PLS), phantom limb pain (PLP), and residual limb pain (RLP) and their correlation with perioperative use of epidural or perineural catheters. METHODS:Postal survey. Patients with trans-femoral, trans-tibial or hemi-pelvectomy amputation were asked to partake in the study. The Prosthetic Evaluation Questionnaire was used for the presence of chronic post-surgical pain. Use of catheters was retrieved from medical notes. RESULTS:57 patients at a mean of 4.4 years follow up were included. PLS was reported in 68.4%, PLP in 63.2 % and RLP in 54.4% of amputees. No correlation was identified between pain syndromes and the presence of individual catheters and the duration of their permanence. The simultaneous use of 2 catheters was related to a lesser presence of PLP. CONCLUSIONS:Data on prevalence of PLP, PLS and RLP are consistent with the literature. Favourable effects in PLP reduction in the long term follow up was related to the simultaneous use of two catheters.
