Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA.
Department of General Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA.
Head Neck. 2022 Jun;44(6):1368-1376. doi: 10.1002/hed.27035. Epub 2022 Mar 22.
Gabapentin has been shown to reduce opioid use in head and neck cancer patients. Here, we examine the efficacy of prophylactic gabapentin at reducing opioid use in these patients at our institution.
A retrospective study of patients receiving radiation was performed, using patients from our previous study as controls. Risk factors for opioid use at 3 and 6 months were determined using univariate and multivariate analyses.
In total, 53/185 patients were treated with gabapentin, 39.6% of which took opioids at 3 months vs. 58.3% in the non-gabapentin cohort (p = 0.021). Gabapentin was independently associated with less opioid use on multivariate analysis at 3 months (OR 0.47, 95% CI 0.24-0.9). Gastrostomy tube dependence and pretreatment opioid use were associated with chronic opioid use despite gabapentin.
Gabapentin is effective at expediting opioid tapering in head and neck cancer patients who are not gastrostomy tube dependent or taking opioids pretreatment.
加巴喷丁已被证明可减少头颈部癌症患者的阿片类药物使用。在这里，我们研究了在我们机构中预防性使用加巴喷丁对减少这些患者阿片类药物使用的效果。
对接受放射治疗的患者进行了回顾性研究，使用我们之前研究中的患者作为对照。使用单变量和多变量分析确定 3 个月和 6 个月时使用阿片类药物的风险因素。
总共 185 例患者中有 53 例接受了加巴喷丁治疗，其中 39.6%的患者在 3 个月时使用阿片类药物，而非加巴喷丁组的这一比例为 58.3%（p=0.021）。多变量分析显示，加巴喷丁与 3 个月时阿片类药物使用减少独立相关（OR 0.47，95%CI 0.24-0.9）。胃造口管依赖和预处理阿片类药物使用与加巴喷丁治疗后慢性阿片类药物使用相关。
对于不依赖胃造口管或预处理时使用阿片类药物的头颈部癌症患者，加巴喷丁可有效加快阿片类药物的减量。
