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Analgesic Medication Usage among Amputees in the United States
Andrew L. O'Brien, MD, MPH, Sumanas W. Jordan, MD, PhD,
Julie West, MS, PA-C, Trevor Hodson, BS,and Ian L. Valerio, MD, MBA, FACS
University Training Program
2019-02-15
Presenter: Andrew O'Brien
Affidavit:
Yes
Director Name: Gregory Pearson
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Post-amputation pain, including stump pain, and phantom limb pain is a pervasive problem with reports of prevalence ranging between 50-90%. Medications prescribed to alleviate this pain can variable. To our knowledge, no recent data has been published on the prevalence of pharmacologic analgesic usage among the amputee population in the United States.
A cross-sectional, observational study was performed using a survey. Surveys were supplied to prosthetists, and outpatient physical therapy clinics across the state of Ohio and United States to distribute to patients. Amputees completed surveys anonymously which were then returned to the authors for analysis.
248 surveys were completed and returned for a response rate of 65.6%. Opioid use for post-amputation pain was reported by over a quarter (28.2%) of respondents. Furthermore, there was no difference in the prevalence of opioid use when stratified by time since amputation, either < 1 year, 1-4 years, 5-9 years, 10 years. Neuromodulators were the most commonly reported daily analgesic medication (45.2%). With NSAIDs, acetaminophen, and aspirin, grouped as "non-opioid pain relievers" being the second most common (44.8%). Finally, the use of antidepressants (19%), benzodiazepines (6.5%), and marijuana (2.4%) were also reported as being utilized for the relief of post-amputation pain.
Opioids represent a large portion of the medications taken to manage post-amputation pain among amputees in the United States. Emerging surgical techniques currently show promise for pain control in this population, including targeted muscle reinnervation. Further, research is needed into effective alternative mechanisms for alleviating pain among this population.
