Chronic post-amputation pain: peri-operative management - Review

Area of Science:

• Pain Management
• Surgical Outcomes
• Genetics and Pain

Background:

• Chronic post-amputation pain (CPAP) is a significant concern for amputees.
• Identifying peri-operative factors influencing CPAP is crucial for improving patient outcomes.

Purpose of the Study:

• To review the existing literature on peri-operative factors associated with chronic post-amputation pain (CPAP).
• To synthesize evidence regarding the influence of pre-operative, intra-operative, and post-operative factors on CPAP development.

Main Methods:

• A narrative review of studies identified through bibliographic database searches.
• Keywords used: 'Amputation' AND 'chronic pain'.
• Analysis focused on associations between peri-operative factors and CPAP.

Main Results:

• Heterogeneity prevented systematic review; narrative synthesis was performed.
• Genetic variations (GCH1, KCNS1) may play a role in CPAP.
• Pre-operative anxiety, depression, and pre-amputation pain are associated with CPAP.
• Evidence for age, gender, and post-operative pain association with CPAP is limited.
• Regional anesthesia and peri-neural catheters show limited evidence for CPAP prevention.

Conclusions:

• Optimized peri-operative analgesia may reduce acute peri-operative pain.
• Current evidence is insufficient to draw firm conclusions on reducing the risk of CPAP.
• Further research is needed to elucidate factors influencing CPAP and develop effective prevention strategies.