Question

Part 1:

HPI: A 78-year-old man who is to undergo a left above the knee amputation due to a limb abscess

PMH: Peripheral artery disease for 18 years; cardiomyopathy, benign prostatic hypertrophy for 13 years

FH: Mother had osteoporosis; father had diabetes

SH: Lives with wife; has two grown children

Meds: Aspirin 81mg daily; atorvastatin 80 mg at bedtime; multivitamin 1 daily; pantoprazole 40 mg daily; tamsulosin 0.4 mg daily

Pain Assessment: Patient rates pain as 8 on a scale of 0 to 10.

• Based on the type of injury, what type of pain is this patient likely to experience?
• What type of pain management regimen would you suggest in the postoperative period? Explain your answer

Answer 1

The patient is experiencing phantom limb pain,this pain occurs during the first week after the amputation. This pain affected in the foot of an amputated leg. The pain will be shooting, stabbing, crushing, needle prick pain, burning and crushing. pain score 8 indicates it is very severe pain and present for a long time.
Pain management regimen:
-Over the counter medication, acetaminophen and ibuprofen can control the pain to some extent.
-Antidepressant drugs relive pain when nerve damage occurs, it treats nerve pain
-Narcotics like morphine and codeine can control phantom pain.
-N-methyl-d-aspartate receptor antagonist works on brain nerve cells and blocks the glutamate activity, protein can control relaying nerve signals.
-Administration of calcitonin IV therapy can treat early postoperative phantom limb pain.