Manejo del síndrome doloroso del miembro fantasma en niños amputados por cáncer: un enfoque integral
DOI:
https://doi.org/10.1016/j.rccot.2016.02.004Palabras clave:
dolor, miembro fantasma, neoplasias, niñosResumen
El propósito de la revisión fue extraer de la bibliografía recomendaciones para el manejo del miembro fantasma doloroso en niños amputados por cáncer, resumidas en una propuesta de un manejo integral.
El síndrome doloroso del miembro fantasma se presenta en el 48-80% de los amputados, ocasiona deterioro de la calidad de vida, incremento del costo de la atención sanitaria y dificulta su rehabilitación. La fisiopatología de esta entidad incluye la interacción de mecanismos periféricos y el procesamiento anormal de la información en el sistema nervioso central.
Su manejo requiere intervenciones enfocadas a la prevención y tratamiento temprano. Las opciones farmacológicas incluyen gabapentinoides, opioides y anti-NMDA (N-metil-D-aspartato). En conclusión, no hay consenso en cuanto a su manejo. Los puntos clave incluyen el control óptimo del dolor previo a la cirugía, el manejo multidisciplinario con clínica del dolor, salud mental, trabajo social y rehabilitación como modelo de atención del paciente amputado.
Nivel de evidencia clínica: Nivel IV.
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