• K-U Kern and D Fangmann.
• Institut für Schmerzmedizin/Schmerzpraxis Wiesbaden, Sonnenberger Strasse 68, Wiesbaden, Germany. dr.kern@schmerzpraxis-wiesbaden.de
• Schmerz. 2013 Apr 1;27(2):174-81.

ObjectivesThe 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.Patients And MethodsFive patients suffering upper and lower extremity phantom pain were successfully treated with tapentadol (prolonged release) with differing doses.ResultsIn 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.ConclusionThe 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.

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