Pandey Chandra K, Bose Neeta, Garg Garima, Singh Namita, Baronia Arvind, Agarwal Anil, Singh Prabhat K, Singh Uttam
Department of Anaesthesiology and Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Anesth Analg. 2002 Dec;95(6):1719-23, table of contents. doi: 10.1097/00000539-200212000-00046.
Pain syndromes of Guillain-Barré are neuropathic as well as nociceptive in origin. We aimed to evaluate the therapeutic efficacy of gabapentin in relieving the bimodal nature of pain in Guillain-Barré syndrome in a randomized, double-blinded, placebo-controlled, crossover study in 18 patients admitted to the intensive care unit for ventilatory support. Patients were assigned to receive either gabapentin (15 mg. kg(-1). d(-1) in 3 divided doses) or matching placebo as initial medication for 7 days. After a 2-day washout period, those who previously received gabapentin received placebo, and those previously receiving placebo received gabapentin as in the initial phase. Fentanyl 2 micro g/kg was used as a rescue analgesic on patient demand or when the pain score was >5 on a numeric rating scale of 0-10. The numeric rating score, sedation score, consumption of fentanyl, and adverse effects were noted, and these observed variables were compared. The numeric pain score decreased from 7.22 +/- 0.83 to 2.33 +/- 1.67 on the second day after initiation of gabapentin therapy and remained low during the period of gabapentin therapy (2.06 +/- 0.63) (P < 0.001). There was a significant decrease in the need for fentanyl from Day 1 to Day 7 during the gabapentin therapy period (211.11 +/- 21.39 to 65.53 +/- 16.17 [ micro g]) in comparison to the placebo therapy period (319.44 +/- 25.08 to 316.67 +/- 24.25 [ micro g]) (P < 0.001).
Gabapentin, an antiepileptic drug, has been used effectively for different types of pain management. This study demonstrates that gabapentin has minimal side effects and is an alternative to opioids and nonsteroidal antiinflammatory drugs for management of the bimodal nature of pain of Guillain-Barré Syndrome patients.
吉兰 - 巴雷综合征的疼痛综合征起源于神经病理性疼痛以及伤害感受性疼痛。我们旨在通过一项随机、双盲、安慰剂对照、交叉研究，评估加巴喷丁对入住重症监护病房接受通气支持的18例吉兰 - 巴雷综合征患者缓解双峰性疼痛的治疗效果。患者被分配接受加巴喷丁（15mg·kg⁻¹·d⁻¹，分3次给药）或匹配的安慰剂作为初始药物治疗7天。经过2天的洗脱期后，先前接受加巴喷丁治疗的患者改为接受安慰剂，先前接受安慰剂治疗的患者改为接受加巴喷丁，治疗方式与初始阶段相同。根据患者需求或当数字评分量表（0 - 10分）上的疼痛评分>5分时，使用2μg/kg的芬太尼作为急救镇痛药。记录数字评分得分、镇静评分、芬太尼消耗量和不良反应，并对这些观察变量进行比较。加巴喷丁治疗开始后第二天，数字疼痛评分从7.22±0.83降至2.33±1.67，且在加巴喷丁治疗期间一直保持较低水平（2.06±0.63）（P<0.001）。与安慰剂治疗期相比，加巴喷丁治疗期从第1天到第7天芬太尼的需求量显著减少（211.11±21.39至65.53±16.17[μg]）（安慰剂治疗期为319.44±25.08至316.67±24.25[μg]）（P<0.001）。
加巴喷丁作为一种抗癫痫药物，已被有效地用于不同类型的疼痛管理。本研究表明，加巴喷丁副作用极小，是治疗吉兰 - 巴雷综合征患者双峰性疼痛的替代阿片类药物和非甾体类抗炎药的药物。
