Acute Postoperative Pain Management After Major Limb Amputation in a Pediatric Patient: A Case Report

Purpose: Although total prevention of phantom pain is difficult, pediatric patients requiring amputation benefit from an individualized combination of analgesic techniques for phantom pain reduction using a multimodal and interprofessional approach. This is especially useful in the event a single therapy is ineffective for total pain reduction, and may ultimately lead to a reduction in chronic pain development. Design: Case report with multimodal and interprofessional approach. Methods: A 16-year-old patient with synovial sarcoma underwent a right hemipelvectomy and hip disarticulation. The patient had significant preoperative cancer pain requiring high-dose opioid analgesics prior to surgery. An interprofessional multimodal pain management strategy was used for acute and long-term reduction of postoperative phantom pain. Findings: Although our patient developed acute phantom pain, multimodal therapy reduced immediate pain with resolution by 2 years follow-up. Conclusions: An individualized plan using interprofessional teamwork before surgery may provide optimal results in alleviating phantom pain after amputation for pediatric patients.