Tan Arif Kenan, Duman Iltekin, Taşkaynatan Mehmet Ali, Hazneci Bülent, Kalyon Tunc Alp
Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, 06018 Etlik, Ankara, Turkey.
Clin Rheumatol. 2007 Apr;26(4):561-5. doi: 10.1007/s10067-006-0350-y. Epub 2006 Aug 8.
The objective of this paper is to investigate the effect of gabapentin in the earlier stage of reflex sympathetic dystrophy syndrome (RSD). Twenty-two patients diagnosed with RSD were enrolled. Initial gabapentin dosage was 600 mg/day. This dosage is increased gradually until a satisfactory pain level was reached. After this level, this dosage was maintained throughout the study. An exercise program was also applied to the patients. Provoked and static pain scores of the patients were obtained initially, at 3-day intervals for maintenance dosage determining, and at 6 weeks after the discharge. Functional improvement parameters were volumetric measurement; dynamometric measurement and third finger pulp-distal palmar crease distance measurement for hands; and metric circumferential measurement and range of motion for elbow, knee, and foot initially, at baseline, on the tenth day, upon discharge, and 6 weeks after the discharge. The mean maintenance dose of gabapentin was 1,145.46+/-377.6 mg/day (range, 900-1,800 mg/day). Improvements in spontaneous and provoked pain intensities were statistically significant. No statistically significant difference was obtained in functional improvement parameters. Dizziness in three patients, headache in two patients, and mild burning feeling in the tongue in one patient were the reported side effects. These symptoms resolved spontaneously in few days. Gabapentin cannot be recommended as the drug of choice, but it may be considered as one of the therapeutic alternatives in the management of pain due to RSD. We suggest that it is effective only for the pain and not for other symptoms of RSD. Serious side effects that will cause the patient to stop using the drug are rare.
本文的目的是研究加巴喷丁在反射性交感神经营养不良综合征（RSD）早期阶段的作用。招募了22名被诊断为RSD的患者。加巴喷丁初始剂量为600毫克/天。该剂量逐渐增加，直至达到满意的疼痛水平。达到该水平后，在整个研究过程中维持该剂量。还对患者实施了一项锻炼计划。最初、在确定维持剂量的3天间隔期以及出院后6周时获取患者的激发痛和静息痛评分。功能改善参数包括：手部的体积测量、握力测量以及第三指腹至远端掌横纹距离测量；肘部、膝盖和足部最初、基线、第10天、出院时以及出院后6周时的周长测量和活动范围。加巴喷丁的平均维持剂量为1145.46±377.6毫克/天（范围为900 - 1800毫克/天）。自发痛和激发痛强度的改善具有统计学意义。功能改善参数未获得统计学上的显著差异。报告的副作用包括3名患者出现头晕、2名患者出现头痛以及1名患者出现舌头轻度烧灼感。这些症状在几天内自行缓解。加巴喷丁不能被推荐为首选药物，但在治疗RSD所致疼痛方面可被视为一种治疗选择。我们认为它仅对疼痛有效，而对RSD的其他症状无效。导致患者停药的严重副作用很少见。
