Department of Neurosurgery, Spine Center, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2020 May 15;10(1):8120. doi: 10.1038/s41598-020-65108-8.
Among patients with cervical myelopathy who were diagnosed with neuropathic pain (NP) by the LANSS test, the study participants were randomly assigned to one of the two study groups. The participants in one study group received opioids only, while those in the other group received opioids and pregabalin. Thirty-nine patients were analyzed in the study (20 patients in the opioid-only group and 19 in the pregabalin add-on group). The LANSS, neck pain, and arm pain scores in the pregabalin add-on group improved significantly compared with those in the opioid-only group after the first 4 weeks (p = 0.005, 0.001 and 0.035, respectively), but there was no significant difference between the two groups during the next 4 weeks (p = 0.615, 0.377 and 0.716, respectively). There was no significant difference in the neck disability index and EuroQol-5Dimension scores after four weeks and eight weeks of follow-up. Adverse events were reported by four patients (20.0%) in the opioid-only group and five patients (26.3%) in the pregabalin add-on group (p = 0.716). However, over time, the occurrence of side effects and dropouts increased in the pregabalin add-on group. This exploratory pilot study suggests that pregabalin add-on treatment is more efficient than the use of opioids alone at the beginning of NP treatment in cervical myelopathy patients. However, prescribing pregabalin add-on treatment for more than four weeks should be done cautiously.
在通过 LANSS 测试诊断为神经性疼痛 (NP) 的颈椎脊髓病患者中，研究参与者被随机分配到两个研究组之一。一组研究参与者仅接受阿片类药物治疗，而另一组则接受阿片类药物和普瑞巴林治疗。在这项研究中，有 39 名患者被分析（阿片类药物组 20 名，普瑞巴林附加组 19 名）。与阿片类药物组相比，普瑞巴林附加组的 LANSS、颈部疼痛和手臂疼痛评分在最初的 4 周内显著改善（p=0.005、0.001 和 0.035），但在接下来的 4 周内两组之间没有显著差异（p=0.615、0.377 和 0.716）。四周和八周随访后，颈痛残疾指数和 EuroQol-5Dimension 评分无显著差异。在阿片类药物组中有 4 名患者（20.0%）和普瑞巴林附加组中有 5 名患者（26.3%）报告了不良反应（p=0.716）。然而，随着时间的推移，普瑞巴林附加组副作用的发生和脱落率增加。这项探索性的初步研究表明，在颈椎脊髓病患者的 NP 治疗开始时，普瑞巴林附加治疗比单独使用阿片类药物更有效。然而，对于超过四周的普瑞巴林附加治疗的处方应该谨慎。
