K-U Kern1, P Bialas, D Fangmann. 1. Institut für Schmerzmedizin/Schmerzpraxis Wiesbaden, Sonnenberger Strasse 68, Wiesbaden, Germany. dr.kern@schmerzpraxis-wiesbaden.de
Abstract
OBJECTIVES: The successful therapy of phantom pain remains a major challenge, because the underlying pathophysiological mechanisms are still not fully understood. A therapeutic approach with tapentadol has not been described so far. PATIENTS AND METHODS: Five patients suffering upper and lower extremity phantom pain were successfully treated with tapentadol (prolonged release) with differing doses. RESULTS: In 4 patients, a strongly reduced pain intensity between 4 and 6.5 on the visual analog scale (VAS) was recorded. The fifth patient reported an increase in the nocturnal sleep duration from 2 to 5 h and a decrease in the number of phantom pain attacks by 30 %. In 2 patients, the additional medication could be lowered or stretched. Side effects (vertigo, fatigue) were only observed in one subject. CONCLUSION: The cases described provide preliminary evidence that the synergistic combination of μ-opioid receptor agonism (MOR) and noradrenalin re-uptake inhibition (NRI) provided by tapentadol may be beneficial in the treatment of phantom pain.
OBJECTIVES: The successful therapy of phantom pain remains a major challenge, because the underlying pathophysiological mechanisms are still not fully understood. A therapeutic approach with tapentadol has not been described so far. PATIENTS AND METHODS: Five patients suffering upper and lower extremity phantom pain were successfully treated with tapentadol (prolonged release) with differing doses. RESULTS: In 4 patients, a strongly reduced pain intensity between 4 and 6.5 on the visual analog scale (VAS) was recorded. The fifth patient reported an increase in the nocturnal sleep duration from 2 to 5 h and a decrease in the number of phantom pain attacks by 30 %. In 2 patients, the additional medication could be lowered or stretched. Side effects (vertigo, fatigue) were only observed in one subject. CONCLUSION: The cases described provide preliminary evidence that the synergistic combination of μ-opioid receptor agonism (MOR) and noradrenalin re-uptake inhibition (NRI) provided by tapentadol may be beneficial in the treatment of phantom pain.
Authors: P Schwenkreis; K Witscher; F Janssen; R Dertwinkel; M Zenz; J P Malin; M Tegenthoff Journal: Neurosci Lett Date: 2000-10-27 Impact factor: 3.046
Authors: Marisol A Hanley; Dawn M Ehde; Kellye M Campbell; Bridget Osborn; Douglas G Smith Journal: Arch Phys Med Rehabil Date: 2006-02 Impact factor: 3.966