Department of Anesthesiology and Pain medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea.
Pain Physician. 2018 Jul;21(4):E429-E434.
Combination therapy with a gabapentinoid and an opioid improves the quality of life (QOL) of patients with chronic pain. However, the role of combination therapy in patients with spinal cord stimulation (SCS) has not been evaluated.
Our primary objective was to evaluate the clinical outcomes of combination therapy consisting of a gabapentinoid and an opioid in patients undergoing SCS.
Retrospective evaluation.
Veterans Health Service Medical Center, Seoul, Korea.
We retrospectively reviewed 100 military veteran patients who underwent SCS implantation. Forty-eight of 100 patients had been maintained on SCS for 2 years. Patients were divided into 2 groups by analgesic type: group A (opioid only, n = 20) and group B (opioid + gabapentinoids, n = 28). Pre-implantation information included the numeric rating scale (NRS) pain score, quality of life scale (QOLS) score, and oral morphine equivalents (OMEs). Post-implantation data were obtained at 1, 6, 12, and 24 months.
Group B had higher QOLS scores at 1, 6, 12, and 24 months than those of group A (P < 0.05). There were no statistically significant differences in the NRS pain score or OMEs at 1, 6, 12, or 24 months between the 2 groups.
Retrospective design, relatively short follow up period (2 years).
This study indicated that the addition of a gabapentinoid to an opioid is superior to an opioid alone in terms of QOL in military veteran patients with SCS for 2 years. Combination therapy consisting of a gabapentinoid added to an opioid can be a good modality to improve QOL in patients with SCS.
Combination, drug therapy, gabapentin, multimodal analgesia, opioid, pain, pregabalin, spinal cord stimulation.
加巴喷丁类药物和阿片类药物联合治疗可改善慢性疼痛患者的生活质量（QOL）。然而，联合治疗在脊髓刺激（SCS）患者中的作用尚未得到评估。
我们的主要目的是评估 SCS 患者中加巴喷丁类药物和阿片类药物联合治疗的临床疗效。
回顾性评估。
韩国首尔退伍军人健康服务医疗中心。
我们回顾性分析了 100 例接受 SCS 植入的退伍军人患者。100 例患者中有 48 例接受 SCS 治疗 2 年。根据镇痛类型将患者分为 2 组：A 组（仅使用阿片类药物，n = 20）和 B 组（阿片类药物+加巴喷丁类药物，n = 28）。植入前信息包括数字评分量表（NRS）疼痛评分、生活质量量表（QOLS）评分和口服吗啡等效剂量（OMEs）。植入后数据在 1、6、12 和 24 个月时获得。
B 组在 1、6、12 和 24 个月时的 QOLS 评分均高于 A 组（P < 0.05）。两组在 1、6、12 或 24 个月时的 NRS 疼痛评分或 OMEs 均无统计学差异。
回顾性设计，随访时间相对较短（2 年）。
本研究表明，在接受 SCS 治疗的退伍军人患者中，加巴喷丁类药物联合阿片类药物治疗在 2 年内的生活质量优于单独使用阿片类药物。加巴喷丁类药物联合阿片类药物的联合治疗可能是改善 SCS 患者生活质量的一种较好方式。
联合治疗；药物疗法；加巴喷丁；多模式镇痛；阿片类药物；疼痛；普瑞巴林；脊髓刺激。
