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Updated: Aug 8, 2026
Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
Published on: March 8, 2024
Continuous brachial plexus blockade in combination with the NMDA receptor antagonist memantine prevents phantom pain
1Department of Anaesthesiology and Intensive Care Medicine, Experimental Pain Research/Pain Centre, University of Heidelberg, Faculty of Clinical Medicine, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. marcus.schley@anaes.ma.uni-heidelberg.de
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.
