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Pharmacologic interventions for treating phantom limb pain.

The Cochrane database of systematic reviews·2016
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Related Experiment Video

Updated: May 26, 2026

Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
03:26

Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain

Published on: March 8, 2024

Pharmacologic interventions for treating phantom limb pain.

Maria Jenelyn M Alviar1, Tom Hale, Monalisa Dungca

  • 1University of Melbourne-Royal Melbourne Hospital, Grattan St, Melbourne, Victoria, Australia, 3010.

The Cochrane Database of Systematic Reviews
|December 14, 2011
PubMed
Summary

Pharmacologic management for phantom limb pain (PLP) remains uncertain. While morphine, gabapentin, and ketamine show short-term pain relief trends, larger trials are needed for definitive recommendations on effective PLP treatments.

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Published on: April 20, 2019

Area of Science:

  • Pharmacology
  • Neurology
  • Pain Management

Background:

  • Phantom limb pain (PLP) is severe, intractable pain experienced in a missing limb post-amputation.
  • Optimal pharmacologic management strategies for PLP are currently uncertain.
  • This review addresses the need for evidence-based treatment guidelines for PLP.

Purpose of the Study:

  • To systematically review the evidence on the effectiveness of pharmacologic interventions for treating phantom limb pain (PLP).
  • To summarize findings on pain intensity, function, mood, sleep, quality of life, and adverse effects.
  • To identify gaps in current research and guide future clinical practice.

Main Methods:

  • Searched major databases (Cochrane, MEDLINE, EMBASE) for randomized and quasi-randomized trials up to September 2011.
  • Included 13 studies with 255 participants comparing pharmacologic treatments to placebo or other interventions.
  • Assessed study quality and extracted data on pain, function, mood, sleep, quality of life, satisfaction, and adverse events.

Main Results:

  • Morphine demonstrated short-term pain reduction but caused adverse effects like constipation and sedation.
  • NMDA receptor antagonists (ketamine, dextromethorphan) showed analgesic effects; ketamine had serious side effects.
  • Gabapentin showed a trend towards pain relief but did not improve function or sleep; amitriptyline was ineffective.

Conclusions:

  • The short- and long-term effectiveness of various drug classes for PLP remains unclear due to study heterogeneity and small sample sizes.
  • Morphine, gabapentin, and ketamine show potential for short-term pain relief, but require cautious interpretation.
  • Larger, rigorous randomized controlled trials are essential to establish effective and safe pharmacologic treatments for PLP.