Management of Phantom Limb Pain Following Amputation in Pediatrics

Phantom limb pain (PLP) presents a significant challenge in pediatric patients following limb amputation, with traditional management strategies often falling short of providing effective relief. This clinical vignette describes the successful utilization of topical ketamine cream as an adjunctive therapy in the multimodal pain management of a 12-year-old female patient who underwent left above-knee amputation (AKA) following traumatic injuries. Despite receiving standard analgesic therapy postsurgery, the patient reported persistent pain at the surgical site and phantom limb sensations, prompting consultation for pain management. Subsequent initiation of topical ketamine cream resulted in marked improvement in pain control and reduction in opioid requirements. The patient's pain continued to decrease over the course of treatment, facilitating the discontinuation of opioids and demonstrating sustained pain relief. This case highlights the unique challenges of managing PLP in pediatric patients and the potential of nonopioid alternatives, such as topical ketamine, in improving pain management outcomes. This case suggests the feasibility and efficacy of topical ketamine cream in pediatric PLP management, emphasizing the need for further research to establish optimal dosing regimens and long-term safety profiles. By expanding our understanding of alternative analgesic modalities, we can enhance pain management outcomes and improve the quality of life for pediatric patients living with PLP.