Brachial plexus block in phantom limb pain: a case report

Pain Med. 2011 Nov;12(11):1649-54. doi: 10.1111/j.1526-4637.2011.01247.x. Epub 2011 Sep 29.

Abstract

Objective: The purpose of this case report is twofold: first, to present evidence of long-lasting relief in a patient suffering from phantom limb pain after pharmacologically blocking his plexus brachialis and, second, to replicate results from a previous study focusing on cortical reorganization and phantom limb pain.

Subject: Before regional anesthesia, the patient suffered from a phantom hand that cramped and was immovable.

Setting: We performed a diagnostic axillary blockade of the brachial plexus to differentiate peripheral from more central contributions to phantom limb pain.

Results: During blockade of the brachial plexus, the patient reported a reduction of phantom limb pain for the first time following years of suffering and a complete loss of cramping together with muscle relaxation of the phantom hand. Additionally, we found cortical reorganization in the primary somatosensory cortex (re-reorganization). Strikingly, the relaxed phantom limb together with the reduction of phantom limb pain remained preserved even 6 months after blockade of the brachial plexus.

Conclusions: A single temporary blockade of the brachial plexus may relieve phantom limb pain and unpleasant phantom feelings (cramping) for an extended period.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthetics / pharmacology*
  • Anesthetics / therapeutic use*
  • Brachial Plexus / drug effects*
  • Brachial Plexus / physiopathology
  • Evoked Potentials, Somatosensory
  • Humans
  • Male
  • Middle Aged
  • Nerve Block*
  • Pain / drug therapy*
  • Pain Measurement
  • Phantom Limb / drug therapy*
  • Sensory Thresholds
  • Somatosensory Cortex / anatomy & histology
  • Somatosensory Cortex / physiology

Substances

  • Anesthetics