Researchers Call for Further Study of Long-Term Post-Amputation Pain Management

While more than 500 amputations are performed daily in the United States, adequate and safe long-term pain management remains a significant issue. 
This topic was recently highlighted in the Journal of Pain Research, which published data showing the extent of this problem. More than 50% of amputees filled an opioid prescription more than three months after their operations.

“Given that post-amputation pain is often diagnosed as a chronic condition, persisting for at least 90 days, our data highlight the need for larger sample sizes and longer-term controlled trials to better understand the advantages and disadvantages of chronic use of gabapentinoids and opioids/opioid combination drugs in this patient population,” the study authors explained.

The literature review identified only four randomized controlled trials that used gabapentinoids or opioids, which resulted in at least 50% pain reduction responder criteria. Furthermore, these studies only measured post-amputation pain over a four- to six-week acute period, highlighting the lack of data on effective long-term post-amputation pain management.

Data from the two gabapentinoid and two opioid trials that met the inclusion criteria were combined into a gabapentinoid and opioid data set. Each set was qualitatively compared with placebo to assess the potential benefits of the drugs in long-term post-amputation pain management. While both medications were more effective than placebo in treating post-amputation pain, opioids were more effective than gabapentinoids with a number needed to treat of 3.9 (95% CI, 2.5-9.3) compared with 8.9 (95% CI, 5.3-27.8), respectively.

The researchers hope to use these data to “inform the next generation of needed studies on the long-term efficacy of these agents.”

—Myles Starr