Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain

Metin, Muzaffer; Eşme, Hıdır; Solak, Okan; Yaman, Mehmet; Pekçolaklar, Atilla; Gürses, Atilla; Kavuncu, Vural

doi:10.1016/j.ejcts.2007.03.022

Cited by 67 publications

(39 citation statements)

References 25 publications

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“…The authors concluded that gabapentin is safe and effective in the treatment of CPTP with minimal side effects and a high patient compliance and suggested that the results be substantiated with multidisciplinary studies with larger sample sizes and longer follow-ups. 39 Other medications such as pregabalin, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, lidocaine patches, and tramadol may be generally employed in the treatment of neuropathic pain. 40 Use of ketamine for chronic neuropathic pain is largely anecdotal and requires further study.…”

Section: Treatment Of Chronic Post-thoracotomy Painmentioning

confidence: 99%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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This article provides a concise overview of post‐thoracotomy pain syndrome, describes anesthetic and surgical factors that have been investigated to reduce the incidence of the syndrome, and explores the effectiveness of various treatments for this condition. Although some interventions (both procedural and pharmacologic) have been investigated in both preventing and treating post‐thoracotomy pain syndrome, definitive studies are lacking and firm conclusions regarding the benefit of any intervention cannot be drawn. The problem is compounded further by our lack of understanding of the pathophysiologic mechanisms underlying the development of chronic pain after surgery. Going forward, it will be important to elucidate these mechanisms and conduct well‐designed trials involving novel therapeutic agents for both prevention and treatment of post‐thoracotomy pain syndrome. Mt Sinai J Med 79:133–139, 2012. © 2012 Mount Sinai School of Medicine

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Section: Treatment Of Chronic Post-thoracotomy Painmentioning

confidence: 99%

Preventing Post‐Thoracotomy Pain Syndrome

Khelemsky

Noto

2012

Mount Sinai J Medicine

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“…In the Gabapentin group, there was significant amelioration of wound pain (p = 0.001). On the 60th day of treatment, 17 (85%) patients of the Gabapentin group were found to have VAS scores of <5 (p = 0.001) [14].…”

Section: Discussionmentioning

confidence: 99%

Pregabalin in Chronic Post-thoracotomy Pain

Mishra

Nar²,

Bawa³

et al. 2013

JCDR

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Introduction: Chronic post-thoracotomy pain (CPP) has very high incidence and therefore it needs attention. Usually, it is burning, dysaesthetic and aching in nature and it displays many features of neuropathic pain. No one technique of thoracotomy has been shown to reduce the incidence of chronic post-thoracotomy pain.Objectives: To evaluate the efficacy and safety of pregabalin in patients with chronic post-thoracotomy pain.Methods: This prospective, randomized study was conducted on 50 consenting patients who underwent posterolateral thoracotomy. 25 patients were given pregabalin for 21 days (Group A). Another 25 were given diclofenac sodium (Group B) on demand and they escaped treatment. Visual Analogue Scale (VAS) scoring was performed on days 0, 1 and 7, then follow up was done at 3, 6, 12 and 24 weeks. The data was analyzed by using 't'-test and Chisquare test for various variables. Results:The pain VAS scores in Group A were significantly low at all observation points except on day 0, day 1 and day 7 postoperatively, when the difference in pain scores in both the groups were comparable. The overall pain scores of Group A were comparable at day 0, day 1 and at day 7 as compared to those of Group B (p>0.9). Pain was significantly low at three weeks (p<0.05). Pain scores of Group A were significantly low at 6 weeks,12 weeks and 24 weeks as compared to those of Group B (p<0.001) and the difference was statistically significant. No significant adverse reactions were observed during study period. Conclusion:Pregabalin is a safe and an effective adjuvant which is used for reducing the chronic post-thoracotomy pain, which has no side effects and a high patient compliance. These results should be supported with multidisciplinary studies with larger sample sizes and longer follow-ups. INTRODUCTIONPain relief is an important part of post-operative care of the patients who undergo any type of surgery. Patients deserve to be as pain free as possible. In addition to patient's comfort, one of the important reasons for good pain management is that the patient needs to participate fully in post-operative rehabilitation like deep breathing, coughing and ambulation, as all these help in preventing unwanted complications [1]. Chronic post-thoracotomy pain has highest incidence and therefore it needs attention. Chronic postthoracotomy pain is defined by the International Association for the Study of Pain as 'a pain that recurs or persists along a thoracotomy incision, at least two months following a surgical procedure' [2]. Usually, it is burning, dysaesthetic and aching in nature, which displays many features of neuropathic pain. It occurs in approximately 50% of patients after thoracotomy and is usually mild or moderate. However, in 5%, the pain is severe and disabling. No one technique of thoracotomy has been shown to reduce the incidence of chronic post-thoracotomy pain [3].The first reference to Chronic Post-thoracotomy Pain (CPP) was made in 1944 by United States Army surgeons who noted 'chronic intercostal pai...

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“…The sample size was determined prospectively using data from previous studies [4,7] in our institution's power and precision analysis program. For purposes of the priori power calculation, a 15% reduction in the NRS acute pain scores in group G was considered to be significant.…”

Section: Biostatistical Analysismentioning

confidence: 99%

“…[4,5] Furthermore, those who undergo a thoracotomy are very likely to develop chronic post-thoracotomy pain, with incidence rates ranging between 50 and 80% having been reported. [6,7] For this reason, minimizing acute pain intensity is important to help reduce the incidence of chronic pain, [6] and different protocols, including preemptive and multimodal strategies, have been used to reduce both of these types of pain.…”

mentioning

confidence: 99%

The effects of the pre-emptive oral gabapentin on post-anesthesia recovery criteria, acute post-thoracotomy pain and development of chronicity in pain with benign thoracotomy operations

Koşucu¹

2014

Turk Gogus Kalp Dama

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The effects of the pre-emptive oral gabapentin on post-anesthesia recovery criteria, acute post-thoracotomy pain and development of chronicity in pain with benign thoracotomy operationsPreemptif oral gabapentinin benign torakotomi ameliyatlarında anestezi sonrası derlenme kriterleri, torakotomi sonrası akut ağrı ve ağrının kronikleşmesi üzerine etkileri So nuç: 1200 mg pre-emptif oral gabapentin derlenme kalitesini artırabilir ve torakostomi sonrasında akut ve kronik ağrıyı azaltabilir.Anah tar söz cük ler: Gabapentin; ağrı; torakotomi. Background:In this article, we evaluated the effects of preemptive oral gabapentin on post-anesthesia recovery criteria and acute and chronic post-thoracotomy pain.Methods: This prospective, randomized, clinical comparison study included 60 ASA II-III class patients undergoing thoracotomy for segmentectomy. The patients were randomly divided into two groups: Group G (n=29) received pre-emptive gabapentin 1200 mg peroral while group C (n=31) received placebo. Anesthetic procedure and post-anesthetic analgesia protocol were standardized. Spontaneous respiration, extubation, swallowing, spontaneous eye opening and verbal cooperation times, sedation, agitation and activity levels and modified Aldrete scores were evaluated. Time to first analgesic requirement, acute post-thoracotomy pain, and postoperative total morphine and additional analgesic consumption were recorded. The chronicity of post-thoracotomy pain was questioned using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) at the end of one year follow-up.Results: Shorter verbal cooperation times (p= 0.012), less agitation (at 15 min, p= 0.001, and 30 min, p= 0.001) and earlier recovery times (p<0.0005, at 15 and 30 min), despite greater sedation (at 15 min, p<0.0005, and 30 min, p= 0.016) were observed in the gabapentin group. The time to first analgesic requirement was delayed (p<0.005 for all follow-up) and, total morphine and additional analgesic consumptions (p<0.0005 for all follow-ups) were consistent with the numerical rating scale scores. Gabapentin reduced persistent post-thoracotomy pain during the first year (at two, three, six, and 12 months; p= 0.040, p=0.031, p=0.001 and p=0.001, respectively).Conclusion:Pre-emptive oral gabapentin 1200 mg may improve the quality of recovery and reduce acute and chronic postthoracotomy pain.

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Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain

Abstract: Gabapentin is safe and effective in the treatment of CPTP with minimal side effects and a high patient compliance. These results should be supported with multidisciplinary studies with larger sample sizes and longer follow-ups.

Cited by 67 publications

References 25 publications

Preventing Post‐Thoracotomy Pain Syndrome

Preventing Post‐Thoracotomy Pain Syndrome

Pregabalin in Chronic Post-thoracotomy Pain

The effects of the pre-emptive oral gabapentin on post-anesthesia recovery criteria, acute post-thoracotomy pain and development of chronicity in pain with benign thoracotomy operations

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