The patient is likely to experience both somatic acute pain classified as nociceptive and Phantom-limb pain, commonly classified as neuropathic. It has been proposed that factors in both the peripheral and central nervous systems play major roles in triggering the development and maintenance of pain associated with extremity amputation (Kuffler, 2017). Pain after amputation involves nociceptive pain, due to bone and soft tissue injury, and neuropathic pain from direct neural trauma and central sensitization (Neil, 2016). What type of pain management regimen would you suggest in the postoperative period? Explain your answer. The patient rates his pain as an 8/10 indicating he is experiencing severe pain which a nsaid or acetaminophen used alone will likely not effectively manage. Due to extensive tissue trauma involved, the immediate post-operative period is dominated by surgical stump pain confined to the surgical area. The severity of the stump pain requires management with strong opioids as a baseline. Morphine delivered via a patient-controlled pump can satisfactorily manage the patient’s pain. With the PCA, there is ease of titration and reliable systemic delivery. pregabalin due to its faster onset and minimal side effects; and a low dose ketamine continuous infusion are known to be helpful in the management of postoperative stump pain (Neil, 2016)
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