ESRA Academy. Assis W. Sep 8, 2016; 138213; 0030 Topic: PHARMACOLOGY OF DRUGS USED IN RA AND PAIN THERAPY
Welma Assis
Welma Assis

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Background and Aims:

Pain in amputation can be Acute nociceptive and / or neuropathic; Chronic pain or phantom phenomenon. The patient usually presents dysesthesia, pain in burning, stabbing, electric shock, or just itching making difficult his recovery and rehabilitation. Neuropathic pain has an negative impact on quality of life of the amputees It required a precise pharmacologic therapy.


Male patient 20 years, with disarticulation of the left foot was amputated. Refers pain like 'burning', 'blazing' and 'crushing' VAS 7 with periods of electric shock paroxysms VAS 10, hyperalgesia and  allodynia. During hospitalization was given Dypirone, Tenoxicam, Gabapentin, Amitriptyline,  Tramadol and Morphine. He was discharged on the 16th day being prescribed Gabapentin, Paracetamol and Tramadol but remaining with episodes of paroxysmal pain in 'shock' VAS 10. In chronic pain clinic it was added the use of lidocaine 5% patch and after that reported a significant improvement with VAS 4, the neuropathic pain described as 'shock' over and the phantom pain disappeared. He had just dysesthesia on the spot maintaining Gabapentin and Lidocaine 5% patch.


Originally indicated for the treatment of post herpetic neuropathy, the local use of Lidocaine 5% plaster expands its indication, being effective in the treatment of other neuropathic pain with hyperalgesia and cutaneous allodynia, as post amputation pain


The reports of the use of lidocaine patch 5% for pain in the amputation stump and phantom limb pain are still scarce, so the present case report demonstrates that this can be a viable alternative in cases of refractory neuropathic amputation pain

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