Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims Phantom limb pain (PLP) remains a challenging condition that is common after limb amputation and has a high prevalence among wounded military personnel. This study evaluates a comprehensive approach that combines long-term peripheral nerve blocks with systemic pharmacologic interventions to address this complex phenomenon.

Methods A randomized trial design was adopted to evaluate the efficacy of two primary treatment modalities: Method 1, consisting of regional anesthesia applied twice at 72-hour intervals, supplemented by fentanyl patch applications; and Method 2, involving prolonged perineural blockade via intraneural catheters over six days. Participants included wounded military personnel experiencing PLP, with interventions tailored based on individual patient characteristics and the anatomical level of amputation.

Results The study included 26 participants, with 73.1% (n=19) undergoing Method 1 and 26.9% (n=7) receiving Method 2. Initial pain scores averaged at 7.1 ± 2.1 on the Visual Analog Scale (VAS), with notable reductions observed post-treatment (3.2 ± 1.6 for Method 1 and 4.1 ± 2.6 for Method 2). Method 1 demonstrated superior efficacy in pain reduction and improvement in sleep quality compared to Method 2.

Conclusions The integrated treatment approach, combining systemic pharmacotherapy with targeted regional anesthesia, significantly alleviates PLP in wounded military personnel, enhancing their quality of life. Method 1 showcased greater effectiveness, underscoring the importance of personalized and adaptable pain management strategies in military medical care. Further research is warranted to optimize treatment protocols and explore the long-term benefits of such integrative approaches.