A prospective study on the role of gabapentin in post-burn pruritus

Zachariah, Jewel Raj; Lakshmanarao, Aravind; Prabha, Ratna; Gupta, Ashish Kumar; Paul, Kingsley M.; Lamba, Shashank

doi:10.1007/s00238-011-0644-4

Cited by 6 publications

(3 citation statements)

References 34 publications

(86 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zachariah et al 29 reported improved mean itch severity scores when gabapentin was given to pediatric and adult patients complaining of pruritus with inadequate relief on antihistamines and emollients. On a scale ranging from 7 to 21, mean itch severity scores fell from 13.35 to 8.36 within 1 month of treatment and this effect was sustained for the 6-month follow-up period.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Neuropathic agents in the management of pruritus in burn injuries: a systematic review and meta-analysis

McGovern

Quasim

Puxty

et al. 2021

Trauma Surg Acute Care Open

View full text Add to dashboard Cite

ObjectivesPruritus is a common and often distressing complication after a burn injury. The purpose of this review is to explore the efficacy of drugs classically used to treat neuropathic pain in the management of pruritus after burn injury.MethodsA systematic literature search of medical databases was conducted to find studies investigating drugs listed in the National Institute for Health and Care Excellence (NICE) guideline (CG173, “neuropathic pain in adults”) for the management of pruritus after burn injury in patients of any age. Controlled studies were stratified by the drug class studied and their risk of bias before conducting meta-analysis. A narrative review of case series or observational studies was presented. Severity of pruritus at any time point, with all quantitative and qualitative measures, was included.ResultsFifteen studies were included in the final analysis, 10 investigated the use of gabapentinoids, 4 studied doxepin, and 1 local anesthetic agents. Meta-analysis of three randomized controlled trials (RCTs) demonstrated that the use of gabapentinoids was associated with an improvement in mean VAS (Visual Analog Scale) 0–10 scores of 2.96 (95% confidence interval (95% CI) 1.20 to 4.73, p<0.001) when compared with placebo or antihistamine. A meta-analysis of four RCTs investigating topical doxepin showed an improvement in mean VAS scores of 1.82 (95% CI 0.55 to 3.09, p<0.001). However, when excluding two studies found to be at high risk of bias, no such improvement was found (−0.32, 95% CI −1.64 to –0.99, p=0.83).ConclusionThis study suggests that gabapentinoids are beneficial in the management of burn-related pruritus. There is a lack of evidence to suggest that doxepin is an effective treatment. Topical local anesthetic agents may be safe and beneficial, but studies are scarce.Level of evidenceSystematic review, level II.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Ten articles [21][22][23][24][25][26][27][28][29][30] investigated gabapentinoids in the management of pruritus after burn injury. Four studies were RCTs (table 1) and six were observational studies with varying methodology (table 2).…”

Section: Gabapentinoidsmentioning

confidence: 99%

Neuropathic agents in the management of pruritus in burn injuries: a systematic review and meta-analysis

McGovern

Quasim

Puxty

et al. 2021

Trauma Surg Acute Care Open

View full text Add to dashboard Cite

show abstract

“…A clinical trial also showed that gabapentin reduced mechanical allodynia following a superficial burn but that this effect was only present in uninjured skin [68]. Gabapentin also reduced burninduced pruritis [69,70] and decreased phantom limb pain following a surgical amputation [71], warranting further investigation into its effectiveness for burn-pain.…”

Section: Current Treatments For Burn Pain and The Need For Novel Analmentioning

confidence: 99%

Progress of clinical practice on the management of burn-associated pain: Lessons from animal models

McIntyre

Clifford

Maani

et al. 2016

Burns

View full text Add to dashboard Cite

Opioid-based analgesics provide the mainstay for attenuating burn pain, but they have a myriad of side effects including respiratory depression, nausea, impaired gastrointestinal motility, sedation, dependence, physiologic tolerance, and opioid-induced hyperalgesia. To test and develop novel analgesics, validated burn-relevant animal models of pain are indispensable. Herein we review such animal models, which are mostly limited to rodent models of burn-induced, inflammatory, and neuropathic pain. The latter two are pain syndromes that provide insight into the pain caused by systemic pro-inflammatory cytokines and direct injury to nerves (e.g., after severe burn), respectively. To date, no single animal model optimally mimics the complex pathophysiology and pain that a human burn patient experiences. No currently available burn-pain model examines effects of pharmacological intervention on wound healing. As cornerstones of pain and wound healing, pro-inflammatory mediators may be utilized for insight into both processes. Moreover, common clinical concerns such as systemic inflammatory response syndrome and multiple organ dysfunction remain unaddressed. For development of analgesics, these aberrations can significantly alter the potential efficacy and/or adverse effects of a prescribed analgesic following burn trauma. We therefore suggest that a multi-model strategy would be the most clinically relevant when evaluating novel analgesics for use in burn patients.

show abstract