ARAÚJO, P. V. S.; OLIVEIRA, R. V.; JÚNIOR, J. L. C.; http://lattes.cnpq.br/5178813548582212; http://lattes.cnpq.br/8353425174706872; http://lattes.cnpq.br/5389519931147085; ARAÚJO, Paulo Victor de Souza.; OLIVEIRA, Raiff Villarim.; COSTA JÚNIOR, Joab Lima da.
Resumen:
Introduction: Phantom limb pain is among the most difficult chronic pain to be treated, and
is a frequent complication of amputation (60-80%), being severe in only 5-10% of cases.
Many drugs have been tested as a treatment of phantom limb pain, with little success so far.
But little is known about preventive ways to avoid phantom limb pain. Amitriptyline is
currently a pharmacological option for the treatment of acute pain, but was never
preemptively administered to control chronic pain. Objectives: To compare the frequency of
incidence of phantom limb pain in patients undergoing amputation between the groups that
received preemptive use of amitriptyline and placebo. Materials and Methods: A clinical
trial, randomized, placebo-controlled, double-blind. Patients with limb amputation statement,
which had their pain assessed by visual analog scale (VAS), Faces Scale of Pain and
Numerical Pain Scale, before surgery and then randomized into two groups, amitriptyline 25
mg and placebo. Upon the completion of the full or partial limb amputation, patients were
evaluated again by the tests mentioned in the 7th day after surgery. Results: In total 84
patients were randomized, but only 18 remained by the end of the study. There was no
statistical difference sufficient to support the hypothesis that preemptive amitriptyline
prevents the emergence of phantom limb pain (p = 0.9522; RR = 0.9545, 95% CI 0.2092 to
4.356). Conclusions: The study sample was small to be able to display a statistically
significant p value (p <0.05), losses are expected in clinical trials with more patients will be
able to better establish the relationship of preemptive amitriptyline with limb pain of
appearance ghost.