Post-amputation pain among lower limb amputees in a tertiary care hospital in Jeddah, Saudi Arabia: A retrospective study

Saudi Med J. 2022 Feb;43(2):187-196. doi: 10.15537/smj.2022.43.2.20210609.

Abstract

Objectives: To estimate the prevalence of post- amputation pain among lower-limb amputees and its burden on their lives.

Methods: A retrospective patients record review of lower limb amputation surgeries was carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between 2008-2019. e collected data included: patients demographics, surgical operations, chronic pain characteristics, functional impairment, and treatment.

Results: A total of 645 lower-limb amputations carried out on 509 patients, 104 (20.4%) patients had more than one amputation surgery carried out, and 40 (7.9%) patients having bilateral amputations. The estimated prevalence of chronic post-amputation pain among the lower-limb amputees was approximately 61.5%. Persistent postoperative neuropathic pain was the most common type of pain following amputation, followed by residual limb pain, then phantom limb pain. The most common cause of amputation was diabetes and its related complications (76%). The mean age at surgery was 57.46±12.02 years. Although diabetes was a common comorbid illness (95.6%), it had no correlation with the development of chronic post-amputation pain. However, peripheral vascular disease had a strong association (p=0.009), especially with the development of phantom limb pain (54.5%; p=0.016). The most common reason for functional impairment among the amputees was disability (52.7%), while only 6.6% said it was secondary to pain.

Conclusion: Post-amputation pain is one of the major consequences of amputation. Pain was poorly managed among these patients. Special considerations should be obtained to manage these patients' pain and reduce their suffering.

Keywords: lower-limb amputation; persistent postoperative neuropathic pain; phantom pain; post-amputation pain; residual limb pain; stump pain.

MeSH terms

  • Amputation, Surgical
  • Amputees*
  • Humans
  • Lower Extremity / surgery
  • Phantom Limb* / epidemiology
  • Retrospective Studies
  • Saudi Arabia / epidemiology
  • Tertiary Care Centers