Epidemiological Investigation Of Phantom Limb Pain In Guangxi

Objective To investigate epidemiological characteristics and relevant risk factors of Phantom limb pain (PLP) in amputee population of GuangXi and provide the epidemiological evidence for standardizing the treatment and prevention of PLP.Methods The questionnaire was designed basing on the etiology, risk factors, clinical features, treatment methods and therapeutic efficacy of phantom limb pain by ourselves. This study collected 960 patients who got amputated in 7 AAA hospitals in GuangXi from January 2005 to December 2009. With the one-person form of questionnaires, trained investigators from the Public Health College of GuangXi Medical University conducted a telephone follow-up survey by one to one. According to the survey results and medical records information, we record and analyze the patient's basic information, operative site, anesthesia method, the clinical manifestation and treatment of PLP, then multivariate logistic regression analysis was performed by all factors that may affect PLP.Results This study investigated 960 cases of amputation patients,226 cases were followed up successfully, the rate of success is 23.54%. The incidence of PLP is 43.36%. The most pain score of PLP is 6.65±2.54, the lightest pain score is 2.24±2.51. Trauma is the largest proportion (57.9%) in all causes of amputation; the time of onset is mostly more than one week after amputation (43.59%); the feeling that pain with numbness is the largest proportion (43.59%) in all characters of pain; the regularity of pain is mostly intermittent (35.90%); the course of pain is mostly about 1～3 months (28.21%) and 1～2 years (28.21%); the duration of pain is mostly about 1～30 minutes (46.15%). There are only 10(10.20%) of patients with PLP received treatment, and the rate of satisfaction was only 30.00%. The four factors that affect the occurrence of PLP include pain before the amputation (OR=2.60), stump pain (OR=3.70), general anesthesia (OR=2.94) and postoperative analgesia (OR=0.44).Conclusions The incidence of PLP is high, the pain is severe, the number of patients receiving treatment is small, the result of treatment is not effective and trauma is the main reason for amputation in amputation patients. That pain before the amputation, stump pain and general anesthesia were found as the relevant risk factors for the development of PLP, and postoperative analgesia is the protective factor. The age, sex, employment, level of education, marital status, reason for amputation, site of amputation, complications, prosthesis is not the relevant factors. Therefore, clinicians should strengthen awareness of PLP, interfere the factors in perioperation and reduce the incidence of PLP, as well as standardizing the treatment and preventing.