Gabapentin for coeliac plexus pain

Pelham, Anne; Lee, Mark; Regnard, Claud

doi:10.1191/0269216302pm548xx

Cited by 6 publications

(5 citation statements)

References 6 publications

(5 reference statements)

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“…23,164,[167][168][169][170][171][172][173][174][175][176][177][178][179][180][181] In a study investigating the efficacy and safety of gabapentin monotherapy in the management of CIPN, 75 cancer patients, who had previously received chemotherapy and had experienced at least one symptom of NP, were included in the intervention group. They received a fixed low dose of gabapentin (800 mg daily).…”

Section: 155mentioning

confidence: 99%

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

et al. 2011

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Neuropathic cancer pain (NCP), commonly encountered in clinical practice, may be cancer-related, namely resulting from nervous system tumor invasion, surgical nerve damage during tumor removal, radiation-induced nerve damage and chemotherapy-related neuropathy, or may be of benign origin, unrelated to cancer. A neuropathic component is evident in about 1/3 of cancer pain cases.Although from a pathophysiological perspective NCP may differ from chronic neuropathic pain (NP), such as noncancer-related pain, clinical practice, and limited publications have shown that these two pain entities may share some treatment modalities. For example, co-analgesics have been well integrated into cancer pain-management strategies and are often used as First-Line options for the treatment of NCP. These drugs, including antidepressants and anticonvulsants, are recommended by evidence-based guidelines, whereas, others such as lidocaine patch 5%, are supported by randomized, controlled, clinical data and are included in guidelines for restricted conditions treatment. The vast majority of these drugs have already been proven useful in the management of benign NP syndromes. Treatment decisions for patients with NP can be difficult. The intrinsic difficulties in performing randomized controlled trials in cancer pain have traditionally justified the acceptance of drugs already known to be effective in benign NP for the management of malignant NP, despite the lack of relevant high quality data. Interest in NCP mechanisms and pharmacotherapy has increased, resulting in significant mechanism-based treatment advances for the future. In this comprehensive review, we present the latest knowledge regarding NCP pharmacological management. n INTRODUCTIONFollowing EFIC's (European Federation of IASP Chapters) declaration in 2001, pain is not a symptom but a disease in its own right, necessitating appropriate treatment. The word pain usually refers to a discrete sensory experience, triggered by an identifiable set of ''painful'' stimuli, acting on a unique or stable ''pain'' pathway and eliciting an invariant sensation. However, pain, and particularly neuropathic pain (NP) can also exist as a diverse group of complex phenomena of unpleasant and distressing nature. NP encloses numerous complicated neurobiologic constituents and reflects potentially dynamic mechanisms, interacting at multiple neuraxial sites. 1Modern neurobiological techniques have led to tremendous progress in the exploration of pain pathogenetic mechanisms. [2][3][4] Research indicates that pain can be produced in multiple ways, at different locations, co-existing between and across various pathological conditions. 5,6 Novel therapeutic targets have been discovered and are used by the pharmaceutical industry for the construction of highly specific molecules, acting as potential innovative analgesics. Recent targets' application, specific to precise NP mechanisms, will very soon enable treatment to be focused at particular mechanisms, introducing a mechanism-based therap...

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Section: 155mentioning

confidence: 99%

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

et al. 2011

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“…A prospective randomized trial proved gabapentin to be effective in improving analgesia in patients with neuropathic cancer pain already treated with opioids, but most likely no specific PCRP were included in this study (70). Only a small case series of gabapentin use in PCRP have been published (71).…”

Section: Pcrp Treatmentmentioning

confidence: 99%

Pancreatic Cancer Related Pain: Review of Pathophysiology and Intrathecal Drug Delivery Systems for Pain Management

2021

Pain Phys

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BACKGROUND: Pancreatic cancer (PC) is one of the most lethal cancers and is the eleventh most common cancer worldwide. This disease is characterized by an often-fatal evolution and a high burden of symptoms, particularly pain. Several studies have demonstrated that pancreatic cancer patients have a high prevalence of pain, with up to 82% of patients reporting pain, often requiring systemic strong opioids as mainstay treatment. This comprehensive review of pancreatic cancer related pain (PCRP), focuses on current mechanisms that lead to pain including regional invasion processes, as well as the local secretion of factors that sensitize nociceptive nerves. OBJECTIVE: Our objective was to conduct a review of PCRP and provide updates on intrathecal drug delivery in PC therapeutic recommendations. STUDY DESIGN: We used a narrative review design. We present a novel perspective in the field of pain research by converging data from intrathecal drug delivery trials with previous elements of molecular pain research in PCRP. METHODS: The literature review relating to PCRP pathophysiology and intrathecal drug delivery systems (IDDS) was done with searches of English, French, and Spanish abstracts, using PubMed, Dynamed, EMBASE, SciELO, Uptodate, Google Scholar, and manual searches of the bibliographies of known primary and review articles from IDDS inception until August 2020. Different search strings based on MESH terms were used including: pain, chronic pain, cancer pain, prevalence, pathophysiology, pancreatic cancer, analgesia, invasive pain procedures, celiac plexus neurolysis, pancreatic neuropathy, intrathecal drug delivery, or a combination of these terms. A narrative review based on these sources was prepared. RESULTS: This paper reviews aspects related to pancreatic adenocarcinoma and PCRP prevalence and focuses on recent developments in pathophysiology with IDDS as a pain management strategy. We summarize the best available evidence regarding intrathecal therapy (IT) for PCRP management; 18 studies of IDDS including at least 236 PC patients are analyzed. LIMITATIONS: Some limitations include: IDDS studies heterogeneity regarding disease stage, patient population, and technical aspects, such as catheter placement and treatment regimen, do not allow integration of studies. CONCLUSION: This review analyzes both past and current literature with a critical analysis of findings and respective recommendations. Most studies of IDDS in PCRP evaluate outcomes on pain using one-dimensional pain scales, such as VAS. Other relevant results, such as performance status or quality of life, are not frequently reported. Burden of disease variables, such as cancer stage, location, and comorbidities, like depression and systemic analgesia co-prescription, are usually not presented in these studies. In the same way, most studies do not precisely inform IDDS titration and IT medication. These factors make integration of IDDS in PC studies difficult. Future studies regarding impact of IDDS on pain control on quality of life, in this particular population, may help clinicians in deciding the optimal time and approach for IDDS. The studies should report data on particular disease, comorbidities, and treatment regimens. KEY WORDS: Adenocarcinoma, cancer pain, pain, pancreatic carcinoma, pancreatic neoplasms, pain management, physiopathology, prevalence

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“…It is likely that the drug possesses a generic analgesic and antihyperalgesic effect by modifying channels involved in nociception (86,96) and neurotransmitter release (133). Confirmation from clinical studies, have shown that gabapentin is effective against pain in cancer patients, as well (134)(135)(136)(137)(138)(139)(140)(141)(142)(143)(144)(145)(146)(147)(148)(149). Gabapentin can be particularly helpful in patients with neuropathic pain (burning pain, shooting pain, allodynia) due to cancer, particularly when pain does not respond to opioids (137,142,147,148,150).…”

Section: Gabapentinmentioning

confidence: 99%

“…Effective doses range between approximately 100 and 3000 mg daily (144). Gabapentin has been also helpful in relieving abdominal pain from upper abdominal malignancies, such as pancreatic cancer infiltrating the celiac plexus, thus sparing the need for blockade of the latter structure (145). It is helpful in reducing pain associated with painful procedures in cancer patients (140), as well as in reducing myoclonic movements associated with the use of high doses of opioids in cancer pain (143).…”

Section: Gabapentinmentioning

confidence: 99%

Advances in the therapy of cancer pain: from novel experimental models to evidence-based treatments

2007

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Gabapentin for coeliac plexus pain

Cited by 6 publications

References 6 publications

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

Pharmacological Treatment of Neuropathic Cancer Pain: A Comprehensive Review of the Current Literature

Pancreatic Cancer Related Pain: Review of Pathophysiology and Intrathecal Drug Delivery Systems for Pain Management

Advances in the therapy of cancer pain: from novel experimental models to evidence-based treatments

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