Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Thomas Herrera, MD: No financial relationships or conflicts of interest
Case Description: The use of dronabinol for three patients with phantom limb pain (PLP).
Setting: Tertiary Care Hospital
Patient: A 36-year-old male with a past medical history of a left transfemoral amputation after an improvised explosive device (IED) blast injury presented to clinic for persistent and severe phantom limb pain (PLP) following interosseous integration surgery. The pain occurred nightly and was refractory to multiple treatment modalities. Dronabinol was started which resulted in decreased intensity and frequency of PLP. This enabled him to eliminate the use of opioids, taper his dose of gabapentin, and improve his sleep. A 35-year-old male with a past medical history of an IED blast injury with subsequent elective right transtibial amputation (TTA) presented to clinic for a two month history of PLP following amputation. PLP was initially well controlled on acetaminophen and gabapentin, but was poorly tolerated due to weight gain and cognitive changes. He discontinued gabapentin and experienced severe PLP at night. He was prescribed dronabinol, which resulted in resolution of his PLP without adverse effects. A 21-year-old male with a history of a left TTA following a motorcycle crash presented with a two year history of PLP. Dronabinol was initiated which resulted in an improvement in frequency and intensity of PLP. He continued to have intermittent episodes of PLP during the middle of the day so he was increased to three times daily dosing resulting in an improvement in symptoms without adverse effects. Assessment/
Results: The use of dronabinol in these patients resulted in decreased intensity and frequency of PLP.
Discussion: Only one case study and no randomized control trials have been conducted evaluating the use of dronabinol for PLP. This is the first case series describing dronabinol as an effective pharmaceutical option for the management of PLP.
Conclusion: Dronabinol may be a safe and effective opioid-sparing pain medication option for PLP.
Level of Evidence: Level V
To cite this abstract in AMA style:Herrera T, Dolomisiewicz E, Kim GM. Dronabinol for Phantom Limb Pain: A Case Series [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/dronabinol-for-phantom-limb-pain-a-case-series/. Accessed September 22, 2023.
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