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Revista de la Sociedad Española del Dolor
versión impresa ISSN 1134-8046
Resumen
SEPULCRE AGULLO, R; GALVEZ MATEOS, R y POZUELO CALVO, R. Use of botulinum toxin for pain after amputation. Rev. Soc. Esp. Dolor [online]. 2021, vol.28, n.6, pp.332-342. Epub 25-Abr-2022. ISSN 1134-8046. https://dx.doi.org/10.20986/resed.2022.3943/2021.
Introduction:
An amputation is a devastating event for all patients who suffer it. It introduces significant changes in the patient's physical, psychic and social spheres. It requires progressive adaptation and reconditioning. Stump pain is one of the most important points in order to control this situation as, on many occasions, it will be what truly determines the patient's life quality. In the recent years, the usefulness of botulinum toxin was studied for pain treatment with encouraging results.
Objetive:
Provide a systematic review on existing scientific literature, with no restrictions on publication year, about the use of botulinum toxin for the pain of amputated patients in order to compile the existing data.
Methodology:
Literature was retrieved from PubMed, EMBASE, Cochrane, Clinical Key, Science Direct, Medes, Dialnet, Scielo and Google Schoolar. The only exclusion criterium was studies carried out on non-human. All documents related to the objective of this research were included independently of year, language, sex, age, type of amputation or botulinum toxin. From 1795 studies found after initial research, 19 studies were selected. The levels of evidence are pertained to 2b, degree of recommendation B (2 pilot studies, randomised, double-blind, with control group) and 4C (2 observational and longitudinal prospective studies, 15 clinical cases).
Results:
It is estimated that an 80.43 % (74 patients) improvement of stump residual pain and/or of the sensation on the phantom limb and a 65.22 % (60 patients) relief of the phantom limb pain and/or of the residual pain. An absence of change of the phantom limb pain was described by 32 patients (34.7 %) and an absence of relief of residual pain was reported on 18 patients (19.57 %). No studies reflect a deterioration of the disease.
Conclusions:
The current study suggests improvement and relief of pain of the phantom limb pain as well as the residual pain in patients treated with botulinum toxin with a 2B level of evidence, degree of recommendation B. Future studies are required to confirm the obtained data.
Palabras clave : Botulinum toxin; amputee; amputated; amputation; residual limb pain; stump pain; phantom limb pain.