Evidence map›Paper›PMID 41089633›Full record

ReviewMedical journal of the Islamic Republic of Iran2025

The Role of Preemptive Perioperative Analgesia in Prevention of Chronic Phantom Pain: A Systematic Review and Meta-analysis.

Ramin Abrishami, Nima Azh, Mehri Farhang Ranjbar, Nogol Motamedgorji

Abstract readReview
In one paragraph

Review in Medical journal of the Islamic Republic of Iran, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

4 authors.

Ramin AbrishamiResearch Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran.
Nima AzhSchool of Medicine, Iran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0002-9180-7197
Mehri Farhang RanjbarResearch Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran.
Nogol MotamedgorjiSchool of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Phantom limb pain (PLP) is a debilitating condition leading to the experience of pain in a limb that has been amputated. Pharmacological interventions have been proposed to prevent chronic PLP. However, results of these interventions are still controversial. This systematic review and meta-analysis clarifies the effectiveness of preemptive pharmacological interventions in prevention of chronic phantom pain by evaluating incidence and intensity of PLP, residual limb pain (RLP), quality of life (QoL), depression, and anxiety. Methods: We systematically searched the PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases for published randomized clinical trials with the outcomes of incidence and intensity for PLP, RLP, QoL, depression, and anxiety in amputation candidates due to any reason. We used the Risk of Bias tool (ROB2) to assess the quality of evidence. Relative risks and mean differences were calculated by a fixed-effects model, and sensitivity analysis was conducted post-hoc for risk of bias. We presented the results using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) tables. Results: Overall, 20 studies were found to address outcomes of interest at 6 months or longer. In 18 studies, intervention was planned for lower limb amputations. Peripheral vascular disease was the most studied cause for amputation. Intervention showed a mean reduction of 0.63 (0.10- 1.15) in 6-month intensity of PLP with low certainty of evidence. Evidence for Ketamine, Gabapentin, Valproic Acid, Calcitonin, Amide local anesthetics such as bupivacaine via epidural and perineural catheters did not support reduction in PLP. Conclusion: Imprecision due to small sample sizes, inadequate blinding, and publication bias downgraded the quality of evidence in this clinical scenario. Overall, preemptive perioperative pharmacological interventions do not seem to prevent phantom pain or stump pain compared with conventional perioperative pain control methods. Further robust studies are required for the effectiveness of Memantine in the prevention of chronic PLP.

Indexed as

Meta-analysisPhantom Limb PainPreventionResidual Limb PainSystematic Review

Identifiers

PMID41089633
PMCPMC12516416

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Registered trials

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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.