OBJECTIVE

The successful therapy of phantom pain remains a major challenge, because the underlying pathophysiological mechanisms are still not fully understood. A therapeutic approach with tapentadol has not been described so far.

METHODS

Five patients suffering upper and lower extremity phantom pain were successfully treated with tapentadol (prolonged release) with differing doses.

RESULTS

In 4 patients, a strongly reduced pain intensity between 4 and 6.5 on the visual analog scale (VAS) was recorded. The fifth patient reported an increase in the nocturnal sleep duration from 2 to 5 h and a decrease in the number of phantom pain attacks by 30 %. In 2 patients, the additional medication could be lowered or stretched. Side effects (vertigo, fatigue) were only observed in one subject.

CONCLUSIONS

The cases described provide preliminary evidence that the synergistic combination of μ-opioid receptor agonism (MOR) and noradrenalin re-uptake inhibition (NRI) provided by tapentadol may be beneficial in the treatment of phantom pain.