Gray Paul, Williams Bronwyn, Cramond Tess
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Pain Med. 2008 Apr;9(3):371-6. doi: 10.1111/j.1526-4637.2006.00149.x.
Pain after burn injury has multiple qualities, including neuropathic and hyperalgesic elements. This element of the burn patients' pain experience is frequently difficult to manage and contributes significantly to their suffering. The onset may be either immediate or delayed. Gabapentin has established efficacy in the reduction of burn-induced hyperalgesia and allodynia in animal and human experimental burn models. This article reports a case series of six patients who, following admission to hospital with burn injury, described burning dysesthesia at either the injury or graft donor site. These patients were prescribed gabapentin in addition to standard analgesia. The use of gabapentin resulted in a rapid reduction in the severity of the neuropathic element of the pain. The medication was well tolerated, with no severe adverse reactions. Conclusions. This case series introduces the use of gabapentin as a potentially important therapy in the management of neuropathic pain following burn injury. Further research is required to define the use of gabapentin in this specific setting.
烧伤后的疼痛具有多种特性,包括神经性和痛觉过敏成分。烧伤患者疼痛体验的这一成分通常难以处理,且极大地加重了他们的痛苦。其发作可能是即时的,也可能是延迟的。在动物和人体实验性烧伤模型中,加巴喷丁已被证实可有效减轻烧伤引起的痛觉过敏和异常性疼痛。本文报告了一个包含6例患者的病例系列,这些患者因烧伤入院后,均描述在受伤部位或植皮供区存在烧灼样感觉异常。除标准镇痛治疗外,还为这些患者开具了加巴喷丁。加巴喷丁的使用使疼痛的神经性成分严重程度迅速降低。该药物耐受性良好,未出现严重不良反应。结论。本病例系列介绍了加巴喷丁作为烧伤后神经性疼痛管理中一种潜在重要治疗方法的应用。需要进一步研究来明确加巴喷丁在这一特定情况下的使用。