Pharmacological Therapies for Pain Management in Patients With Amputation: A Systematic Review and Network Meta-Analysis

Published on June 4, 2026

Pain Res Manag. 2026;2026(1):e3654470. doi: 10.1155/prm/3654470.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of pharmacological therapies for pain management in postamputation patients through a systematic review and network meta-analysis of existing evidence.

METHODS: This systematic review and network meta-analysis (NMA) was conducted following the PRISMA-NMA guidelines and registered in PROSPERO (CRD42024500600). In September 2024, two independent reviewers searched the Cochrane Library, LILACS, PubMed/MEDLINE, SciELO, ScienceDirect, Web of Science, Scopus, CINAHL, and Google Scholar. The eligibility criteria included systematic reviews (with or without meta-analysis) evaluating pharmacological interventions in populations aged 18 years or older.

RESULTS: Seventeen studies met the inclusion criteria and were described in narrative form. Among these studies, seven systematic reviews of randomized clinical trials contained data suitable for NMA. Two primary outcomes were assessed: residual limb pain and phantom limb pain. Analysis of the three subnetworks revealed no statistically significant differences in either direct or indirect comparisons across the evaluated therapies.

CONCLUSION: Current evidence is insufficient to support the efficacy and safety of specific pharmacological therapies for pain management in patients with amputation compared to placebo or alternative treatments.

PMID:42237775 | DOI:10.1155/prm/3654470

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