Nina Stockfleth Buch

The role of afferent input in postamputation pain: a randomized, double-blind, placebo-controlled crossover study

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The role of afferent input in postamputation pain : a randomized, double-blind, placebo-controlled crossover study. / Buch, Nina Stockfleth; Ahlburg, Peter; Haroutounian, Simon; Andersen, Niels Trolle; Finnerup, Nanna Brix; Nikolajsen, Lone.

In: Pain, Vol. 160, No. 7, 07.2019, p. 1622-1633.

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@article{5f57402904a04de180dc4faae2959a10,
title = "The role of afferent input in postamputation pain: a randomized, double-blind, placebo-controlled crossover study",
abstract = "In this randomized, double-blind, placebo-controlled crossover study, we investigated if a peripheral nerve block could temporarily eliminate phantom and stump pain after amputation. Amputees with constant postamputation pain were included and randomized to receive a nerve block with lidocaine 2{\%} with adrenaline or saline in a crossover design. Spontaneous phantom and stump pain and evoked responses were assessed at baseline and at fixed time points until 120 minutes after lidocaine or saline injection. The primary outcome was the difference in absolute change between worst pain intensity, either phantom or stump pain, at baseline and at 30 minutes after lidocaine or saline injection. Twelve amputees were randomized and 9 patients were included in the analysis. The absolute change in median worst pain intensity between lidocaine and saline injection was -2.0 (IQR, -4.0-0.0) (n = 9, P = 0.12). Nine out of 9 patients reported at least some pain relief after lidocaine injection compared to only 2 out of 9 patients after saline injection (P = 0.02). Phantom pain intensity was significantly reduced after lidocaine compared with saline injection (P = 0.04), whereas there was no significant change in stump pain intensity between the two interventions (P = 0.17). In all 9 amputees, evoked responses were eliminated after lidocaine injection. Thus, our findings suggest that afferent input from the peripheral nervous system plays an important role in postamputation pain.",
keywords = "Peripheral nerve block, Phantom pain, Postamputation pain, Stump pain",
author = "Buch, {Nina Stockfleth} and Peter Ahlburg and Simon Haroutounian and Andersen, {Niels Trolle} and Finnerup, {Nanna Brix} and Lone Nikolajsen",
year = "2019",
month = "7",
doi = "10.1097/j.pain.0000000000001536",
language = "English",
volume = "160",
pages = "1622--1633",
journal = "Pain",
issn = "0304-3959",
publisher = "IASP Press",
number = "7",

}

RIS

TY - JOUR

T1 - The role of afferent input in postamputation pain

T2 - a randomized, double-blind, placebo-controlled crossover study

AU - Buch, Nina Stockfleth

AU - Ahlburg, Peter

AU - Haroutounian, Simon

AU - Andersen, Niels Trolle

AU - Finnerup, Nanna Brix

AU - Nikolajsen, Lone

PY - 2019/7

Y1 - 2019/7

N2 - In this randomized, double-blind, placebo-controlled crossover study, we investigated if a peripheral nerve block could temporarily eliminate phantom and stump pain after amputation. Amputees with constant postamputation pain were included and randomized to receive a nerve block with lidocaine 2% with adrenaline or saline in a crossover design. Spontaneous phantom and stump pain and evoked responses were assessed at baseline and at fixed time points until 120 minutes after lidocaine or saline injection. The primary outcome was the difference in absolute change between worst pain intensity, either phantom or stump pain, at baseline and at 30 minutes after lidocaine or saline injection. Twelve amputees were randomized and 9 patients were included in the analysis. The absolute change in median worst pain intensity between lidocaine and saline injection was -2.0 (IQR, -4.0-0.0) (n = 9, P = 0.12). Nine out of 9 patients reported at least some pain relief after lidocaine injection compared to only 2 out of 9 patients after saline injection (P = 0.02). Phantom pain intensity was significantly reduced after lidocaine compared with saline injection (P = 0.04), whereas there was no significant change in stump pain intensity between the two interventions (P = 0.17). In all 9 amputees, evoked responses were eliminated after lidocaine injection. Thus, our findings suggest that afferent input from the peripheral nervous system plays an important role in postamputation pain.

AB - In this randomized, double-blind, placebo-controlled crossover study, we investigated if a peripheral nerve block could temporarily eliminate phantom and stump pain after amputation. Amputees with constant postamputation pain were included and randomized to receive a nerve block with lidocaine 2% with adrenaline or saline in a crossover design. Spontaneous phantom and stump pain and evoked responses were assessed at baseline and at fixed time points until 120 minutes after lidocaine or saline injection. The primary outcome was the difference in absolute change between worst pain intensity, either phantom or stump pain, at baseline and at 30 minutes after lidocaine or saline injection. Twelve amputees were randomized and 9 patients were included in the analysis. The absolute change in median worst pain intensity between lidocaine and saline injection was -2.0 (IQR, -4.0-0.0) (n = 9, P = 0.12). Nine out of 9 patients reported at least some pain relief after lidocaine injection compared to only 2 out of 9 patients after saline injection (P = 0.02). Phantom pain intensity was significantly reduced after lidocaine compared with saline injection (P = 0.04), whereas there was no significant change in stump pain intensity between the two interventions (P = 0.17). In all 9 amputees, evoked responses were eliminated after lidocaine injection. Thus, our findings suggest that afferent input from the peripheral nervous system plays an important role in postamputation pain.

KW - Peripheral nerve block

KW - Phantom pain

KW - Postamputation pain

KW - Stump pain

U2 - 10.1097/j.pain.0000000000001536

DO - 10.1097/j.pain.0000000000001536

M3 - Journal article

C2 - 30817438

VL - 160

SP - 1622

EP - 1633

JO - Pain

JF - Pain

SN - 0304-3959

IS - 7

ER -