Are inmediate-release opioids useful for phantom limb pain? Clinical case

Abstract

When a limb amputation is performed, neuropathic pain may occur in 80% of patients. The therapeutic approach of this pain, is a complex aspect. Usually, coadjuvant neuromodulator are used to control pain in a complementary way to opiates (gabapentin, bupivacaine, pregabalin), but in many cases these measures are not effective. Neuropathic breakthrough pain crises are described and, because of the half-life and pharmacokinetic behavior of neuromodulatory drugs, pain control is not achieved. In our experience, the use of fast-release opioids in the intranasal- peptine presentation in crisis of breakthrough neuropathic pain led to its disappearance or the reduction to tolerable levels.