Pregabalin in severe burn injury pain: A double-blind, randomised placebo-controlled trial

被引:59
作者
Gray, Paul [1 ,2 ,3 ,4 ]
Kirby, Julie [1 ]
Smith, Maree T. [3 ,5 ]
Cabot, Peter J. [3 ]
Williams, Bronwyn [1 ]
Doecke, James [6 ]
Cramond, Tess [1 ,2 ]
机构
[1] Royal Brisbane & Womens Hosp, Prof Tess Cramond Multidisciplinary Pain Ctr, Brisbane, Qld 4029, Australia
[2] Univ Queensland, Sch Med, Brisbane, Qld 4029, Australia
[3] Univ Queensland, Sch Pharm, Pharm Australia Ctr Excellence, Brisbane, Qld 4102, Australia
[4] Royal Brisbane & Womens Hosp, Dept Anaesthesia & Perioperat Med, Brisbane, Qld 4029, Australia
[5] Univ Queensland, Ctr Integrated Preclin Drug Dev, Brisbane, Qld 4072, Australia
[6] Royal Brisbane & Womens Hosp, CSIRO Math Informat & Stat, Commonwealth Sci & Ind Res Org, Brisbane, Qld 4029, Australia
关键词
Pain management; Burn injury; Pregabalin; Randomised placebo-controlled trial; Neuropathic pain scale; Itch; REFLEX SYMPATHETIC DYSTROPHY; CENTRAL NEUROPATHIC PAIN; GAMMA-AMINOBUTYRIC-ACID; SECONDARY HYPERALGESIA; POSTHERPETIC NEURALGIA; THERMAL-INJURY; GABAPENTIN; ANXIETY; MODEL; EFFICACY;
D O I
10.1016/j.pain.2011.01.055
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
This randomised, double-blind, placebo-controlled trial assessed the efficacy and tolerability of pregabalin to alleviate the neuropathic component of moderate to severe burn pain. Patients aged 18 to 65 years admitted to a burns unit with a 5% or greater total body surface area burn injury were screened to participate in the trial. Using the Neuropathic Pain Scale (NPS), patients scoring 4 or higher on 'hot' pain or 'sharp' pain were invited to participate. Consenting patients were randomly assigned to receive pregabalin or placebo for 28 days with individual dose titration commencing at 75 mg twice daily to a maximum pregabalin dose of 300 mg twice daily. The primary outcome measure was the patients' daily response to the sharp and hot pain of the NPS. Secondary outcome measures included the remaining elements of the NPS, daily opioid requirement, length of hospital stay, pain at 6 months, and side effects of nausea, vomiting, drowsiness and giddiness. For patients administered pregabalin, the primary outcome measures hot (P = .01) and sharp (P = .04) pain were significantly reduced compared with those in patients administered placebo. Secondary outcome measures of itch, unpleasantness, surface pain, and procedural pain were significantly lower (P < .05) in the pregabalin group. Adverse effects were uncommon, with no difference between the treatment groups. There was no significant difference between the pregabalin and placebo treatment groups with respect to opioid consumption, duration of hospital stay, or pain at 6 months. Pregabalin was efficacious and well tolerated in patients after severe burn injury and whose pain was characterised by features of acute neuropathic pain. (C) 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:1279 / 1288
页数:10
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