Gabapentin in Phantom Limb Pain Management in Children and Young Adults

Rusy, Lynn M.; Troshynski, Todd J.; Weisman, Steven J.

doi:10.1016/s0885-3924(00)00243-8

Cited by 73 publications

(26 citation statements)

References 19 publications

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“…Because it does not appear to significantly affect hematopoiesis, gabapentin may be the drug of choice for children with cancer and NP. It has been used successfully in the treatment of phantom limb pain in adults (Bone, Critchley, & Buggy, 2002), children and adolescents (Bone, Critchley, & Buggy, 2002; Rusy, Troshynski, & Weisman, 2001) and for cancer-related NP in adults (Caraceni et al, 2004) and children (Jacob, 2004). Gabapentin has been in use for NP at St. Jude since 1997.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Pain in Children after Limb-Sparing Surgery: An Institution's 26-Year Experience

Anghelescu¹,

Oakes²,

Hankins³

2011

Pain Management Nursing

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A significant proportion of patients report long-term pain that is 5 or above on a 0 to 10 intensity scale after limb-sparing surgery for malignancies of the long bones. Patients experience several distinct types of pain after limb-sparing surgery, which constitute a complex clinical entity of pain post-limb sparing surgery. This retrospective study examined 26 years of experience in a pediatric institution (1981 through 2007) in pain management as far as 6 months after limb-sparing surgery and reviewed the historical evolution of pain interventions. One hundred and fifty patients underwent 151 limb-salvage surgeries for bone cancer of the extremities in this series. Pain treatment increased progressively in complexity. Therapies included opioids, nonsteroidal antiinflammatory drugs, acetaminophen-opioid combinations, postoperative continuous epidural infusion, anticonvulsants and tricyclic antidepressants for neuropathic pain, local anesthetic wound catheters, and continuous peripheral nerve block catheters. Management of pain after limb-sparing surgery has evolved over the 26 years of this review. It presently relies on multiple "layers" of pharmacological and nonpharmacological strategies to address the complex mixed nociceptive and neuropathic mechanisms of pain in this patient population.

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Section: Discussionmentioning

confidence: 99%

Treatment of Pain in Children after Limb-Sparing Surgery: An Institution's 26-Year Experience

Anghelescu¹,

Oakes²,

Hankins³

2011

Pain Management Nursing

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“…After reviewing medical literature, it became evident that GBP and TGB are the efficacious drugs in reducing acute and chronic pain in the experimental models of nociception (Shimoyama et al, 1997;Hunter et al, 1997;Ipponi et al, 1999;Lu and Westlund, 1999;Laughlin et al, 2002). Moreover, some authors indicated the clinical efficacy of GBP in the treatment of pain neuropathy after herpes zoster (Rowbotham et al, 1998;Rice and Maton, 2001;Serpell et al, 2002), trigeminal neuralgia (Carrazana and Schachter, 1998), peripheral neuropathy in patients with diabetes (Backonja et al, 1998, Backonja, 1999, or phantom limb pain (Rusy et al, 2001). With respect to TGB, it has significantly reduced sensitive neuropathy in patients resistant to the standard antinociceptive therapy (Novak et al, 2001).…”

Section: Controlmentioning

confidence: 99%

Tiagabine Synergistically Interacts with Gabapentin in the Electroconvulsive Threshold Test in Mice

Łuszczki

Świąder

Parada-Turska

et al. 2003

Neuropsychopharmacol

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Polytherapy, based on the rational combining of antiepileptic drugs (AEDs), is required for patients with drug-resistant epilepsy. In such cases, the combinations of AEDs usually offer a significant enhancement of their protective effects against seizures. There has appeared a hypothesis that combining two AEDs, influencing the same neurotransmitter system, results in the potentialization of their anticonvulsant effects. For corroborating this hypothesis, a pharmacological character of interaction between tiagabine (TGB) and gabapentin (GBP)Ftwo novel AEDs affecting the GABA-ergic system, in the maximal electroshock seizure threshold (MEST)-test in mice was evaluated. TGB at the dose of 4 mg/kg and GBP at 75 mg/kg significantly raised the electroconvulsive threshold. Further, using the isobolographic calculations, TGB was coadministered with GBP at three fixed-ratios (1 : 3, 1 : 1, and 3 : 1) of their respective protective drug doses. All examined combinations of TGB with GBP exerted supra-additive (synergistic) interactions against MEST-induced seizures in mice. The interaction index, describing the strength and magnitude of interaction, ranged between 0.25 and 0.50 indicating supraadditivity. Adverse (neurotoxic) effects were evaluated in the chimney (motor performance) and the step-through, light-dark passive avoidance (long-term memory) tests in mice. The examined combinations of TGB with GBP did not affect the motor coordination, except for the fixed-ratio of 1 : 1, at which significant impairment of motor performance was observed. Moreover, all combinations selectively impaired the acquisition of the task in the passive avoidance test, having no impact on consolidation and retrieval in the longterm memory test. The pain threshold test revealed that the observed disturbances in the passive avoidance testing resulted presumably from the antinociceptive activity of these AEDs in combinations. After lengthening the exposing time to the direct current stimulus in the passive avoidance test from 2 to 6 s, the acquisition of the task, in animals receiving the combinations of TGB and GBP was not impaired. Neither the plasma, nor brain concentrations of GBP were affected by TGB application, so pharmacokinetic events that might negatively influence the observed effects are not probable. Results of this study clearly indicate that the activation of the same neurotransmitter system (GABA-ergic) leads to a synergistic interaction. The pain threshold test is a very good paradigm for screening the antinociceptive properties of AEDs, which may disturb the long-term memory testing in animals. Combinations of TGB with GBP (very promising from a preclinical point of view) should be clinically verified for elaborating the most effective treatment regimen in patients with intractable seizures.

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“…Although tricyclic antidepressants and gabapentin are well-established analgesics for these conditions in adults, evidence for efficacy in children is confined to case reports or very small case series. 7,8 Only 1 randomized controlled trial on 28 children has been conducted to evaluate multimodal approaches for CRPS I. Lee et al showed that a 6-week course of cognitive-behavioral therapy combined with either 3 times weekly or once-weekly physiotherapy sessions reduced pain and disability in children. 9 Moreover, no study has yet evaluated what treatments work for those children and adolescents who do not respond to a multimodal treatment approach.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Pamidronate for Treating Intractable Chronic Neuropathic Pain

Brown

Jeavons²,

Stinson³

2005

The Clinical Journal of Pain

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The objective of this study is to evaluate the effectiveness of pamidronate for the treatment of chronic neuropathic pain refractory to previous management. Intravenous pamidronate (60 mg/day for 3 days) was administered to 2 adolescents with neuropathic pain refractory to previous multidisciplinary treatments. Pain intensity, functional improvement, and adverse effects were evaluated. There were no significant reductions in pain intensity or improvements in function initially or at follow-up at 1 week, 1 month and 4 months. Minor side effects included myalgia and skeletal pain that were relieved by acetaminophen. There was no long-term morbidity. In contrast to recent positive reports in adults, pamidronate was not effective in decreasing pain or improving function in 2 adolescents with chronic neuropathic pain. Pamidronate may be effective only when pain is accompanied by abnormal bone density. Future trials should include scans to document bone density pretherapy and posttherapy.

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Gabapentin in Phantom Limb Pain Management in Children and Young Adults

Cited by 73 publications

References 19 publications

Treatment of Pain in Children after Limb-Sparing Surgery: An Institution's 26-Year Experience

Treatment of Pain in Children after Limb-Sparing Surgery: An Institution's 26-Year Experience

Tiagabine Synergistically Interacts with Gabapentin in the Electroconvulsive Threshold Test in Mice

Effectiveness of Pamidronate for Treating Intractable Chronic Neuropathic Pain

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