Altiparmak Basak, Cil Hemra, Celebi Nalan
Mugla Sitki Kocman University, Department of Anesthesiology and Reanimation, Mugla, Turquia.
University of California, Department of Orthopedics and Traumatology, San Francisco, Estados Unidos.
Braz J Anesthesiol. 2019 Mar-Apr;69(2):137-143. doi: 10.1016/j.bjan.2018.08.003. Epub 2018 Nov 16.
Gabapentin is an antiepileptic drug. Widely used for the management of neuropathic pain. Although it is known to be well tolerated, somnolence and dizziness are the most frequent adverse effects. In this study, we aimed to evaluate the effect of melatonin on daytime sleepiness side effect of gabapentin, sleep quality and pain intensity of patients with neuropathic pain.
Patients suffering from “neuropathic pain” and planed to receive gabapentin therapy were randomly divided into two groups. Group 1 received melatonin 3 mg and gabapentin 900 mg orally, group 2 received matching placebo capsule and gabapentin 900 mg. The Epworth Sleepiness Scale, the Pittsburgh sleep quality index for assessment of sleep quality and Verbal Rating Scale were completed at the 0th, 10th and 30th days of treatment. Additive analgesic drug requirements were recorded.
Eighty patients were enrolled to the study; age, gender, ratio of additive analgesic consumption, baseline Epworth Sleepiness Scale, Pittsburg Sleep Quality index and Verbal Rating Scale scores were similar between the groups. Epworth Sleepiness Scale scores, Pittsburgh sleep quality index scores and Verbal Rating Scale scores in Group 1 were significantly lower than group 2 at the 10th day of treatment ( = 0.002, = 0.003, = 0.002 respectively). At the 30th day of treatment, Epworth Sleepiness Scale scores and Verbal Rating Scale scores were significantly lower in Group 1 ( = 0.002, = 0.008 respectively). However, Pittsburgh sleep quality index scores did not significantly differ between the groups ( = 0.0566).
Melatonin supplementation rapidly and significantly improved daytime sleepiness side-effect of gabapentin, however sleep quality of the patients with neuropathic pain was similar between groups.
加巴喷丁是一种抗癫痫药物,广泛用于治疗神经性疼痛。尽管已知其耐受性良好,但嗜睡和头晕是最常见的不良反应。在本研究中,我们旨在评估褪黑素对加巴喷丁引起的日间嗜睡副作用、睡眠质量以及神经性疼痛患者疼痛强度的影响。
患有“神经性疼痛”且计划接受加巴喷丁治疗的患者被随机分为两组。第1组口服3毫克褪黑素和900毫克加巴喷丁,第2组口服匹配的安慰剂胶囊和900毫克加巴喷丁。在治疗的第0天、第10天和第30天完成爱泼沃斯嗜睡量表、用于评估睡眠质量的匹兹堡睡眠质量指数和言语评定量表。记录额外镇痛药物的需求量。
80名患者纳入本研究;两组之间的年龄、性别、额外镇痛药物消耗量比例、基线爱泼沃斯嗜睡量表、匹兹堡睡眠质量指数和言语评定量表评分相似。治疗第10天时,第1组的爱泼沃斯嗜睡量表评分、匹兹堡睡眠质量指数评分和言语评定量表评分显著低于第2组(分别为P = 0.002、P = 0.003、P = 0.002)。治疗第30天时,第1组的爱泼沃斯嗜睡量表评分和言语评定量表评分显著更低(分别为P = 0.002、P = 0.008)。然而,两组之间的匹兹堡睡眠质量指数评分无显著差异(P = 0.0566)。
补充褪黑素可迅速且显著改善加巴喷丁引起的日间嗜睡副作用,然而两组神经性疼痛患者的睡眠质量相似。