Gabapentenoids in pain management in urological chronic pelvic pain syndrome: Gabapentin or pregabalin?

Agarwal, Mayank Mohan; Sy, Mudelin Elsi

doi:10.1002/nau.23225

Cited by 31 publications

(26 citation statements)

References 16 publications

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“…For instance, patients without COPCs may be more likely to benefit from local therapy (eg, intravesical instillation of local anesthetics) than systemic therapy during flares, which also reduces the potential for systemic side effects. In contrast, patients with COPCs may be less likely to benefit from bladder/pelvic‐directed treatments alone and, instead, may require systemic or multimodal therapies for centrally mediated mechanisms (eg, tricyclic antidepressants, gabapentinoids, nonsteroidal anti‐inflammatory drugs, mindfulness‐based stress reduction, and guided imagery). Therefore, asking patients about their extrapelvic symptoms during flares may help tailor their flare management.…”

Section: Discussionmentioning

confidence: 99%

“…Whole body pain was investigated by asking participants to mark areas where they felt "pain or discomfort" that day and to indicate their average level of pain in each marked area (scale = 0-10) on two whole body maps (front and back) modified from the Brief Pain Inventory 7 (BPI; Figure A1). Similar to previous MAPP analyses, we grouped the 42 extrapelvic areas (all areas except for [14][15][16] into the following seven regions: back, head, right leg, left leg, right arm, left arm, and trunk. 8 For pelvic and genital pain, participants reported their average levels of pain or discomfort in six (male) or seven (female) pelvic/genital areas (scale = 0-10), using sex-appropriate diagrams modified from the BPI ( Figure A2).…”

Section: Daily Symptom Assessmentmentioning

confidence: 99%

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Changes in whole body pain intensity and widespreadness during urologic chronic pelvic pain syndrome flares—Findings from one site of the MAPP study

Lai

Pakpahan

et al. 2019

Neurourology and Urodynamics

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Objective To investigate changes in whole body pain during urologic chronic pelvic pain syndrome (UCPPS) flares. Materials and Methods UCPPS participants at one site of the multidisciplinary approach to the study of chronic pelvic pain research network reported their daily flare status and pain levels in 7 pelvic/genital and 42 extrapelvic body areas (scale = 0‐10) for 10 days at baseline and during their first flare. Linear mixed models and conditional logistic regression were used to investigate symptom changes during flares. Analyses were stratified by chronic overlapping pain condition (COPC) status. Results Fifty‐five out of 60 participants completed the study, 27 of whom provided information on both nonflare (n = 281) and flare (n = 208) days. Pelvic/genital pain intensity (mean change = 3.20 of 10) and widespreadness (mean = 1.48) increased significantly during flares for all participants (all P interaction > .1), whereas extrapelvic pain intensity increased significantly only among participants with COPCs (mean = 2.09; P interaction < .0001). Pelvic/genital and extrapelvic pain also varied on nonflare days but symptom fluctuations were generally ≤1 point (80.0%‐100% of participants). Increases of ≥2 points in pelvic/genital pain intensity (odds ratio (OR) = 22.0, 95% confidence interval (CI) = 4.0‐118.6) and ≥1 point in urination‐related pain (OR = 9.10, 95% CI = 1.74‐47.7) were independently associated with flare onset for all participants. Conclusion Our observations of extrapelvic pain increases during flares for patients with COPCs and our independent associations between pelvic/genital/urination‐related pain intensity and flare onset may provide insight into mechanisms underlying flare development (eg, common biologic pathways between UCPPS phenotypes and flares), flare management (eg, local vs systemic therapies by COPC status), and patient flare definitions.

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Section: Discussionmentioning

confidence: 99%

Section: Daily Symptom Assessmentmentioning

confidence: 99%

Changes in whole body pain intensity and widespreadness during urologic chronic pelvic pain syndrome flares—Findings from one site of the MAPP study

Lai

Pakpahan

et al. 2019

Neurourology and Urodynamics

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“…In a study, 119 CPP patients were evaluated and anticonvulsants such as gabapentin and pregabalin were found to be effective in the treatment of CPP. [32] Cheong et al [33] reported that gabapentin was superior to amitriptyline. According to the results of the Cochrane database systematic review, pregabalin was not effective in patients with chronic prostatitis.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Pelvic pain rehabilitation

Vural¹

2018

Turk J Phys Med Rehab

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Chronic pelvic pain is defined as persistent painful condition which lasts for at least six months under umbilicus. Numerous factors are blamed for etiopathogenesis, and quality of life of individuals is adversely affected. Chronic pain as well as functional disorders are accompanied to chronic pelvic pain. The treatment and rehabilitation program should be tailored for specific causes, targeting general pain treatment. Consequently, chronic pelvic pain management can be used to propose personalized treatment options and include patient education, behavioral therapy, and a biopsychosocial approach. Interdisciplinary teamwork and collaboration are essential for facilitating patient-centered rehabilitation.

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“…[3][4][5] It also inhibits central neuronal sensitization and hyperalgesia by acting on calcium channels located at postsynaptic and presynaptic junctions resulting in the inhibition of the calcium influx thereby decreasing excitatory amino acid neurotransmission. 6,7 By decreasing the central sensory input processing 8 , gabapentin is considered to provide preemptive analgesia hence, decreasing the incidence of hyperalgesia and allodynia after surgery. The opioid consumption was found to be reduced in several pain states when gabapentin was co-administered clinically.…”

Section: Introductionmentioning

confidence: 99%

Effects of Gabapentin on Postoperative Pain after Laparoscopic Cholecystectomy

Bhardwaj¹,

Kumar²

2019

IJCMR

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Introduction: Postoperative pain prevention and treatment continues to be a major challenge in postoperative care. Gabapentin has recently become a part of a wide array of postoperative multimodal analgesic regimens. Present study evaluated the efficacy of oral gabapentin in relief of acute post-operative pain in laparoscopic cholecystectomy and also compared the efficacy of oral Gabapentin with that of oral Tramadol. Material and Methods: Sixty ASA I and II physical status patients of both sexes between 20-60 years of age scheduled for elective laparoscopic cholecystectomy were enrolled into this prospective, double blinded, randomized sequential allocation study. Any patient who was unwilling and uncooperative, ASA III and IV physical status, patients having body weight exceeding 20% of ideal body weight, known hypersensitive to any drug, drug or alcohol abuse, pregnant patient, uncontrolled concomitant medical diseases, history of chronic pain conditions, impaired kidney or liver function, laparoscopic cholecystectomy converted to open cholecystectomy, in whom some kind of analgesics were administered within 48 hrs of planned surgery were excluded from the study. Result: Sixty patients (30 males) were enrolled in the study with mean ages of all three groups range from 37.40±9.18 to 41.70±6.84. However the mean age, weight and sex distribution among different groups were statistically insignificant (P>0.05). Mean heart rate in various groups at different intervals were insignificant (p>0.05) in the intra operative period. Among group I, II and III in the postoperative period, changes in mean heart rate was statistically significant (p<0.05). The changes in mean SBP and DBP were statistically insignificant (p>0.05) intraoperatively in the three groups. Conclusion: Premedication with oral 300 mg gabapentin provides better pain relief in the postoperative period as compare to oral 100 mg tramadol and placebo group with minimal side effects.

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Gabapentenoids in pain management in urological chronic pelvic pain syndrome: Gabapentin or pregabalin?

Abstract: Gabapentin may be more effective than pregabalin in UCPPS.

Cited by 31 publications

References 16 publications

Changes in whole body pain intensity and widespreadness during urologic chronic pelvic pain syndrome flares—Findings from one site of the MAPP study

Changes in whole body pain intensity and widespreadness during urologic chronic pelvic pain syndrome flares—Findings from one site of the MAPP study

Pelvic pain rehabilitation

Effects of Gabapentin on Postoperative Pain after Laparoscopic Cholecystectomy

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