Evidence map›Paper›PMID 39971386›Full record

Observational studyRegional anesthesia and pain medicine2026

Perineuromal hydrodissection for acute postamputation pain? An observational study in a time of war.

Dmytro Dmytriiev, Winnie Liu, Maksym Barsa, Andreii Khomenko, Andreii Strokan, Paul F Pasquina, Steven P Cohen

3 registry-linked trialsAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Regional anesthesia and pain medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07380789 narecruitingnot on this map

Management of Acute Pain After Thoracic Combat Trauma: A Multicenter Study in Ukraine

TypeinterventionalSponsorLviv National Medical UniversityRan2026 to 2026Enrolled50ConditionsPain Management, Thoracic Trauma, Pulmonary Function, Quality of LifeArmsCryoablation, Radiofrequency ablation alone
NCT07416448 narecruitingnot on this map

Comprehensive Multicenter Study on the Management of Neuroma-Associated Pain Following Combat-Related Trauma in Ukraine

TypeinterventionalSponsorUkrainian Society of Regional Anesthesia and Pain TherapyRan2026 to 2027Enrolled50ConditionsPain Management, Quality of Life, Neuroma, Functional OutcomeArmscryoablation, Radiofrequency ablation alone
NCT07431944 nanot yet recruitingnot on this map

SILENCE-NEUROMA Trial: Silencing Neuroma Pain-Botulinum Toxin Versus Local Anesthetic Injection in a Randomized Controlled Trial

TypeinterventionalSponsorCharitable Organisation Charitable Fund Superhumans (Co Cf Superhumans)Ran2026 to 2026Enrolled100ConditionsPain Management, Pain, Phantom Limb Pain, Phantom Limb Pain After AmputationArmsBotulinium toxin type A injection, Local Anesthesia
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Dmytro DmytriievAnesthesiology and pain medicine, Vinnitskij Natsionalnij Medichnij Universitet, Vinnitsiya, Ukraine.ORCID http://orcid.org/0000-0001-6067-681X
Winnie LiuJohns Hopkins School of Medicine, Baltimore, Maryland, USA.
Maksym BarsaDepartment of Anesthesiology, Semenyuk Rivne Regional Clinical Hospital, Rivne, Ukraine.
Andreii KhomenkoDept of Anesthesiology and Intensive Care, Feofaniya Clinical Hospital of the State Management of Affairs of Ukraine, Kyiv, Ukraine.
Andreii StrokanDept of Anesthesiology and Intensive Care, Feofaniya Clinical Hospital of the State Management of Affairs of Ukraine, Kyiv, Ukraine.
Paul F PasquinaDept of Physical Medical & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Steven P CohenDept of Physical Medical & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA steven.cohen@northwestern.edu.ORCID http://orcid.org/0000-0001-5928-2127

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis exploratory study investigates the potential of perineuromal hydrodissection as an adjunct to opioid therapy for postamputation pain, specifically focusing on residual limb and phantom limb pain (PLP). Given the correlations between acute pain and the development of chronic pain, the primary aims were to estimate the effect size of early hydrodissection of scar tissue around residual limb neuroma(s) and to identify the best time frame for treatment.

methodsSeventy-four patients with war-related limb amputations and painful neuromas were included in this observational analysis. Thirty-eight Ukrainian patients with war-related limb amputation and a painful neuroma(s) who underwent hydrodissection and opioid therapy within 6 months of amputation were compared with 36 patients who received opioids alone. Co-primary outcome measures were median reduction from baseline in average residual limb and PLP at 12 weeks. The composite positive outcome was designated as a ≥2-point decrease or 30% reduction in average residual limb and PLP, satisfaction with treatment, and not requiring an increase in analgesics.

resultsHydrodissection as an add-on to opioids resulted in a greater reduction in average residual limb pain at 12 weeks (-2.00±1.00 vs -1.00±1.00; p<0.001) and earlier time periods, but PLP only through 4 weeks. At 12 weeks, Hospital Anxiety and Depression Scale anxiety (10.00±2.00 vs 11.00±1.00; p<0.001) but not depression score was lower in the hydrodissection group. Opioid use in the hydrodissection group significantly declined from 41.32±9.63 to 33.42±8.78 morphine equivalents per day (p=0.001) over the study, but not in the opioid-only group (p=0.20). Differences in 12-week satisfaction rates were not significant.

conclusionsThis exploratory study suggests perineuromal hydrodissection may improve residual limb pain and to a lesser degree phantom limb pain, particularly when implemented early in the course of postamputation pain. The study provides preliminary effect size estimates and identifies acute pain as a potential characteristic of patients who may respond more favorably to this intervention. Randomized controlled trials are needed to confirm these findings and control for the confounding variables identified.

Indexed as

Acute PainAmputation, SurgicalPhantom LimbPostoperative PainWarfareAdultAnalgesics, OpioidFemaleHumansMaleMiddle AgedPain MeasurementTreatment OutcomeAnalgesics, OpioidAcute PainAnalgesics, OpioidOpioidsOUTCOMESPain Management

Identifiers

PMID39971386
PMCPMC13422112

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.