{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:01:24Z","timestamp":1791536484935,"version":"4.3.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NRE"],"published-print":{"date-parts":[[2021,8,14]]},"abstract":"<jats:p>BACKGROUND: Chronic pain is common in patients who undergo lower limb amputation. The use of epidural or perineural catheters seems to reduce acute pain after surgery but their effects in a longer follow up are unknown. OBJECTIVE: To evaluate the long-term prevalence of phantom limb sensation (PLS), phantom limb pain (PLP), and residual limb pain (RLP) and their correlation with perioperative use of epidural or perineural catheters. METHODS: Postal survey. Patients with trans-femoral, trans-tibial or hemi-pelvectomy amputation were asked to partake in the study. The Prosthetic Evaluation Questionnaire was used for the presence of chronic post-surgical pain. Use of catheters was retrieved from medical notes. RESULTS: 57 patients at a mean of 4.4 years follow up were included. PLS was reported in 68.4%, PLP in 63.2 % and RLP in 54.4% of amputees. No correlation was identified between pain syndromes and the presence of individual catheters and the duration of their permanence. The simultaneous use of 2 catheters was related to a lesser presence of PLP. CONCLUSIONS: Data on prevalence of PLP, PLS and RLP are consistent with the literature. Favourable effects in PLP reduction in the long term follow up was related to the simultaneous use of two catheters.<\/jats:p>","DOI":"10.3233\/nre-210077","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T14:41:38Z","timestamp":1624372898000},"page":"129-138","source":"Crossref","is-referenced-by-count":8,"title":["Chronic pain in lower limb amputees: Is there a correlation with the use of perioperative epidural or perineural analgesia?"],"prefix":"10.1177","volume":"49","author":[{"given":"Maria Grazia","family":"Benedetti","sequence":"first","affiliation":[{"name":"Physical Therapy and Rehabilitation Unit, University of Bologna - IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"De Santis","sequence":"additional","affiliation":[{"name":"Physical Therapy and Rehabilitation Unit, University of Bologna - IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Mariani","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit \u2013IRCCS \u2013Istituto Ortopedico Rizzoli, Bologna, BO, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Donati","sequence":"additional","affiliation":[{"name":"Physical Therapy and Rehabilitation Unit, University of Bologna - IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Bardelli","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation Unit \u2013IRCCS \u2013Istituto Ortopedico Rizzoli, Bologna, BO, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariada","family":"Perrone","sequence":"additional","affiliation":[{"name":"Anesthesia and Post-Operative Intensive Care, IRCCS-Istituto ortopedico Rizzoli, Bologna, BO, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Fondazione Santa Lucia, Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/NRE-210077_ref1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4103\/0973-1075.197944","article-title":"Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: A prospective, observational study","volume":"23","author":"Ahmed,","year":"2017","journal-title":"Indian J Palliat Care"},{"issue":"5","key":"10.3233\/NRE-210077_ref2","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.ejvs.2014.07.002","article-title":"Continuous Regional Anaesthesia Provides Effective Pain Management and Reduces Opioid Requirement Following Major Lower Limb Amputation","volume":"48","author":"Ayling,","year":"2014","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"10.3233\/NRE-210077_ref3","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/0304-3959(88)90288-6","article-title":"Phantom limb pain in Amputees during the first 12 months following limb amputation, after preoperative lumbar epidural blockade","volume":"33","author":"Bach,","year":"1988","journal-title":"Pain"},{"issue":"3","key":"10.3233\/NRE-210077_ref4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/09593985.2017.1288283","article-title":"Non-pharmacological conservative therapy for phantom limb pain: a systematic review of randomised controlled trials","volume":"33","author":"Batsford,","year":"2017","journal-title":"Physiother Theory Pract"},{"key":"10.3233\/NRE-210077_ref5","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1213\/ANE.0b013e3181f4e848","article-title":"The use of prolonged peripheral neural blockade after lower extremity amputation: the effect on symptoms associated with phantom limb syndrome","volume":"111","author":"Borghi,","year":"2010","journal-title":"Anesth Analg"},{"issue":"2","key":"10.3233\/NRE-210077_ref6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ejvs.2015.04.030","article-title":"Systematic Review and Meta-analysis of the Efficacy of Perineural Local Anaesthetic Catheters after Major Lower Limb Amputation","volume":"50","author":"Bosanquet,","year":"2015","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"2","key":"10.3233\/NRE-210077_ref7","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.apmr.2014.09.035","article-title":"Efficacy of progressive muscle relaxation, mental imagery, and phantom exercise training on phantom limb: a randomized controlled trial","volume":"96","author":"Brunelli,","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"key":"10.3233\/NRE-210077_ref8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.comppsych.2014.10.018","article-title":"The relationship between prosthesis use, phantom pain and psychiatric symptoms in male traumatic limb amputees","volume":"59","author":"Durmus,","year":"2015","journal-title":"Compr Psychiatry"},{"issue":"3","key":"10.3233\/NRE-210077_ref9","doi-asserted-by":"crossref","first-page":"155","DOI":"10.12968\/bjon.2002.11.3.10063","article-title":"A review of amputation, phantom pain and nursing responsibilities","volume":"11","author":"Ellis,","year":"2002","journal-title":"Br J Nurs"},{"issue":"8","key":"10.3233\/NRE-210077_ref10","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1053\/apmr.2000.7583","article-title":"Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation","volume":"81","author":"Ehde,","year":"2000","journal-title":"Arch Phys Med Rehabil"},{"key":"10.3233\/NRE-210077_ref11","first-page":"179","article-title":"Continuous regional analgesia by intraneural block: effect on postoperative opioid requirements and phantom limb pain following amputation","volume":"31","author":"Elizaga,","year":"1994","journal-title":"J Rehabil Res Dev"},{"key":"10.3233\/NRE-210077_ref12","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1016\/j.apmr.2005.03.031","article-title":"Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey","volume":"86","author":"Ephraim,","year":"2005","journal-title":"Arch Phys Med Rehab"},{"key":"10.3233\/NRE-210077_ref13","first-page":"1","article-title":"Measuring long-term outcome in people with lower limb amputation: cross-validation of the Italian versions of the Prosthetic Profile of the Amputee and Prosthesis Evaluation Questionnaire","volume":"41","author":"Ferriero,","year":"2005","journal-title":"Eur Medicophys"},{"key":"10.3233\/NRE-210077_ref14","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1213\/00000539-199103000-00004","article-title":"Continuous postoperative regional analgesia by nerve sheath block for amputation surgery \u2013a pilot study","volume":"72","author":"Fisher,","year":"1991","journal-title":"Anesth Analg"},{"issue":"1","key":"10.3233\/NRE-210077_ref15","first-page":"1","article-title":"Assistive technologies for pain management in people with amputation: a literature review","volume":"5","author":"Ghoseiri,","year":"2018","journal-title":"Mil Med Res"},{"key":"10.3233\/NRE-210077_ref16","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1258\/RSMSMJ.53.1.4","article-title":"The effect of intra-neural local anaesthetic infusion on pain following major lower limb amputation","volume":"53","author":"Grant,","year":"2008","journal-title":"Scott Med J"},{"key":"10.3233\/NRE-210077_ref17","first-page":"324","article-title":"Prevention of phantom pain after major lower limb amputation by epidural infusion of diamorphine, clonidine and bupivacaine","volume":"76","author":"Jahangiri,","year":"1994","journal-title":"Ann R Coll Surg Engl"},{"key":"10.3233\/NRE-210077_ref18","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1097\/ALN.0b013e31820fc7d2","article-title":"Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial","volume":"114","author":"Karanikolas,","year":"2011","journal-title":"Anesthesiology"},{"issue":"6","key":"10.3233\/NRE-210077_ref19","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.cjtee.2018.04.006","article-title":"Phantom limb pain: A literature review","volume":"21","author":"Kaur,","year":"2018","journal-title":"Chin J Traum"},{"key":"10.3233\/NRE-210077_ref20","first-page":"504","article-title":"Perioperative Pain Management Strategies for Amputation: A Topical Review","volume":"18","author":"Kent,","year":"2017","journal-title":"Pain Med"},{"key":"10.3233\/NRE-210077_ref21","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s12035-017-0717-x","article-title":"Origins of Phantom Limb Pain","volume":"55","author":"Kuffler,","year":"2018","journal-title":"Mol Neurobiol"},{"key":"10.3233\/NRE-210077_ref22","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1053\/rapm.2001.23934","article-title":"Randomized prospective study comparing preoperative epidural and intraoperative perineural analgesia for the prevention of postoperative stump and phantom limb pain following major amputation","volume":"26","author":"Lambert,","year":"2001","journal-title":"Reg Anesth Pain Med"},{"key":"10.3233\/NRE-210077_ref23","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S0003-9993(98)90090-9","article-title":"Prosthesis evaluation questionnaire for persons with lower limb amputations: assessing prosthesis-related quality of life","volume":"79","author":"Legro,","year":"1998","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"10.3233\/NRE-210077_ref24","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13643-018-0938-8","article-title":"The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol","volume":"8","author":"Limakatso,","year":"2019","journal-title":"Syst Rev"},{"key":"10.3233\/NRE-210077_ref25","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.jclinane.2006.07.008","article-title":"The efficacy of postoperative perineural infusion of bupivacaine and clonidine after lower extremity amputation in preventing phantom limb and stump pain","volume":"19","author":"Madabhushi,","year":"2007","journal-title":"J Clin Anesth"},{"key":"10.3233\/NRE-210077_ref26","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1016\/S0140-6736(97)06315-0","article-title":"Randomised trial of epidural bupivacaine and morphine in prevention of stump and phantom pain in lower-limb amputation","volume":"350","author":"Nikolajsen,","year":"1997","journal-title":"Lancet"},{"key":"10.3233\/NRE-210077_ref27","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.2106\/00004623-199610000-00007","article-title":"Continuous postoperative infusion of a regional anesthetic after an amputation of the lower extremity. A randomized clinical trial","volume":"78","author":"Pinzur,","year":"1996","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"10.3233\/NRE-210077_ref28","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.pmn.2014.10.006","article-title":"A clinical evaluation of postamputation phenomena including phantom limb pain after lower limb amputation in dysvascular patients","volume":"16","author":"Richardson,","year":"2015","journal-title":"Pain Manag Nurs"},{"issue":"2","key":"10.3233\/NRE-210077_ref29","doi-asserted-by":"crossref","first-page":"75","DOI":"10.11622\/smedj.2013028","article-title":"Incidence of phantom limb phenomena after lower limb amputations in a Singapore tertiary hospital","volume":"54","author":"Sin,","year":"2013","journal-title":"Singapore Med J"},{"issue":"4","key":"10.3233\/NRE-210077_ref30","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1177\/2049463717736492","article-title":"Chronic post-amputation pain: peri-operative management - Review","volume":"11","author":"Srivastava,","year":"2017","journal-title":"Br J Pain"},{"issue":"8","key":"10.3233\/NRE-210077_ref32","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.avsg.2010.03.026","article-title":"Pre-emptive analgesia for chronic limb pain after amputation for peripheral vascular disease: a systematic review","volume":"24","author":"Ypsilantis,","year":"2010","journal-title":"Ann Vasc Surg"},{"issue":"1","key":"10.3233\/NRE-210077_ref33","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1515\/sjpain-2017-0170","article-title":"Efficacy and safety of epidural, continuous perineural infusion and adjuvant analgesics for acute postoperative pain after major limb amputation \u2013a systematic review","volume":"18","author":"Von Plato,","year":"2018","journal-title":"Scand J Pain"}],"container-title":["NeuroRehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/NRE-210077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:06:12Z","timestamp":1777615572000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/NRE-210077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,14]]},"references-count":32,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3233\/nre-210077","relation":{},"ISSN":["1053-8135","1878-6448"],"issn-type":[{"value":"1053-8135","type":"print"},{"value":"1878-6448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,14]]}}}