Methadone for phantom limb pain.

OBJECTIVE The objective of this case series was to determine if severe phantom limb pain could be reduced with oral methadone. DESIGN Four cases of phantom limb pain refractory to multiple treatment modalities were treated with oral methadone. SETTING Pain clinic at a major university medical center. PATIENTS Four patients with severe, intractable phantom limb pain. INTERVENTION Oral methadone was administered, starting with a low dose of 2 to 5 mg twice a day or three times a day and slowly titrated upward to achieve pain relief. OUTCOME MEASURES Repeated administration of a visual analog scale for pain. RESULTS AND CONCLUSIONS Administration of oral methadone may be of value in the treatment of phantom limb pain; controlled clinical trials would be appropriate to verify this observation.