美金刚治疗严重幻肢痛缓解2例

本文报道2例因下肢严重创伤后并发难治性幻肢痛（PLP）大剂量阿片类药物和辅助镇痛药物治疗无效的病例。2例患者均接受大剂量口服美沙酮、静脉PCA二氢吗啡酮和辅助性药物（包括三环类抗抑郁药、非甾体抗炎药和抗癫痫类药物）的治疗，幻肢痛未得到控制。而口服NMDA受体拮抗剂美金刚后，幻肢痛得到缓解，且没有明显的副作用。

We present the cases of two patients who suffered severe lower extremity injuries and subsequently developed phantom limb pain （PLP） that was refractory, to high dose opioids and adjunctive pain medications. Both patients were receiving large doses of oral methadone, IV hydromorphone via a patient-controlled analgesia delivery system, and adjunctive medications including tricyclic antidepressants, nonsteroidal anti-inflammatory medications, and anti-epileptics. Despite these treatments, the patients had severe PLP. Upon induction of the oral N-methyl-D-aspartate receptor antagonist memantine, both patients had a profound reduction in their PLP without anv apparent side effects from the medication.