Systematic Review of the Efficacy and Safety of Gabapentin and Pregabalin for Pain in Children and Adolescents

Egunsola, Oluwaseun; Wylie, C. E.; Chitty, Kate M.; Buckley, Nicholas A.

doi:10.1213/ane.0000000000003936

Cited by 40 publications

(38 citation statements)

References 35 publications

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“…Pregabalin has many features that promote its use preoperatively, particularly preemptive analgesia and a potential neuroprotective effect [9][10][11] . According to a recently published systemic review of the efficacy and safety of gabapentin and pregabalin for pain in children and adolescents the evidencebased data supporting the use of these drugs is very sparse 27 . In the adult population preoperative pregabalin has been shown in many studies to reduce postoperative pain and opioid consumption in patients undergoing posterior spinal fusion [4][5][6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion

Helenius

Oksanen

Lastikka

et al. 2019

The Journal of Bone and Joint Surgery

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Background: Pregabalin as part of a multimodal pain management regimen has been shown to reduce opioid consumption after spinal surgery in adults, but not in adolescents. Pregabalin has been found to have neuroprotective effects and could therefore have positive impact on pain after spinal deformity surgery. We conducted a randomized, double-blind, placebo-controlled clinical trial with pregabalin on pediatric patients undergoing spinal fusion. Methods: Adolescents with adolescent idiopathic scoliosis, Scheuermann kyphosis and spondylolisthesis, aged 10 to 21 years, scheduled for posterior spinal fusion with all pedicle screw instrumentation were randomized to receive preoperatively and five days after surgery either pregabalin 2mg/kg twice daily or placebo. The primary outcome was total opioid consumption and was measured using patient-controlled analgesia. Postoperative pain scores and opioid adverse effects were evaluated. Results: Sixty-three patients out of 77 eligible were included and analyzed. Cumulative oxycodone consumption per kilogram did not differ between the study groups during the first 48 hours postoperatively, median (95% confidence interval) 1.44 mg/kg (1.32-1.67) in the pregabalin vs. 1.50 mg/kg (1.39-1.79) in the placebo group, p=0.433. Subgroup analysis with only AIS patients showed the same result, mean (95% confidence interval) 1.45 mg/kg (1.24, 1.65) in pregabalin group and 1.59 mg/kg (1.37, 1.82) in placebo group. Total oxycodone consumption per hour (mg/kg/h) was not different between the groups over the time points (p=0.752). The postoperative pain scores did not differ statistically between the study groups (p=0.196). Conclusions: Paediatric pregabalin 2 The use of perioperative pregabalin does not reduce the opioid consumption or affect the pain scores in adolescents after posterior spinal fusion surgery.

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Section: Discussionmentioning

confidence: 99%

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion

Helenius

Oksanen

Lastikka

et al. 2019

The Journal of Bone and Joint Surgery

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“…Peripheral neuropathies are prevalent in COVID-19 patients and may require an addition of gabapentinoids to the pain treatment regime [ 62 ]. The gabapentinoids (gabapentin and pregabalin) are commonly used in pain management in adults, but there is a scarcity of research on their effectiveness in children [ 109 ]. Gabapentin and pregabalin are calcium channel α2-δ ligands commonly used in the treatment neuropathic pain.…”

Section: Neuropathic Pain Treatment In Sars-cov-2 Infectionmentioning

confidence: 99%

COVID-19: Pain Management in Patients with SARS-CoV-2 Infection—Molecular Mechanisms, Challenges, and Perspectives

et al. 2020

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Since the end of 2019, the whole world has been struggling with the pandemic of the new Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). Available evidence suggests that pain is a common symptom during Coronavirus Disease 2019 (COVID-19). According to the World Health Organization, many patients suffer from muscle pain (myalgia) and/or joint pain (arthralgia), sore throat and headache. The exact mechanisms of headache and myalgia during viral infection are still unknown. Moreover, many patients with respiratory failure get admitted to the intensive care unit (ICU) for ventilatory support. Pain in ICU patients can be associated with viral disease itself (myalgia, arthralgia, peripheral neuropathies), may be caused by continuous pain and discomfort associated with ICU treatment, intermittent procedural pain and chronic pain present before admission to the ICU. Undertreatment of pain, especially when sedation and neuromuscular blocking agents are used, prone positioning during mechanical ventilation or extracorporeal membrane oxygenation (ECMO) may trigger delirium and cause peripheral neuropathies. This narrative review summarizes current knowledge regarding challenges associated with pain assessment and management in COVID-19 patients. A structured prospective evaluation should be undertaken to analyze the probability, severity, sources and adequate treatment of pain in patients with COVID-19 infection.

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“…Most reviews (n = 19; 40.4%) included variations of mixed chronic pain populations (e.g., abdominal pain, headaches or migraines, widespread pain/fibromyalgia, complex regional pain syndrome, neuropathic pain, sickle cell disease, cancer pain, back pain, and/or pelvic pain). 8,37,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] Reviews focused on single populations most frequently examined abdominal pain (n = 10; 21.3%), 10,35,39,40,57,[59][60][61]77,78 headaches or migraines (n = 5; 10.6%), [62][63][64][65][66] rheumatological conditions (e.g., juvenile idiopathic arthritis, lupus; n = 4; 8.5%), [67][68][69][70] cancer-related pain (n = 3; 6.4%), [71][72][73] or sickle cell disease (n = 2; 4.3%). 74,75 Single reviews focused on patellar tendon pain/Osgood-Schlatter's (n = 1; 2.1%), 76 cerebral palsy (n = 1; 2.1%), …”

Section: Types Of Populationsmentioning

confidence: 99%

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

Birnie

Ouellette

Amaral

et al. 2020

Canadian Journal of Pain

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Background: Reviews in pediatric chronic pain often focus on only one intervention or population, making it difficult for policymakers and decision makers to quickly synthesize knowledge to inform larger-scale policy and funding priorities. Aims: The aims of this study were to (1) create an evidence and gap map of interventions for pediatric chronic pain and (2) identify gaps between existing evidence and recently identified patient-oriented research priorities. Methods: We performed a systematic review of English-language peer-reviewed systematic reviews or clinical practice guidelines of pediatric chronic pain intervention published in the past 20 years. Database searches of Medline, Embase, PsycINFO, Web of Science, CINAHL, and SCOPUS were conducted inclusive to June 3, 2019. Review quality was assessed using the AMSTAR-2. Results: Of 4168 unique abstracts, 50 systematic reviews (including 2 clinical practice guidelines) crossing diverse pediatric chronic pain populations and intervention settings were included. One third were rated high quality, with half rated low to critically low quality. The largest proportion of reviews addressed psychological and pharmacological interventions, followed by interdisciplinary, other (e.g., dietary), and physical interventions. Most common outcomes included pain, physical, emotional, and role functioning and quality of life. Treatment satisfaction and adverse events were less common, with minimal report of sleep or economic factors. Most patient-oriented research priorities had not been investigated. Conclusions: Sufficient quality evidence is available to guide evidence-informed policies in pediatric chronic pain, most notably regarding psychological and pharmacological interventions. Numerous evidence gaps in patient-oriented research priorities and treatment outcomes should guide prioritization of research funds, as well as study aims and design. RÉSUMÉ Contexte: Les études sur la douleur chronique chez les enfants se concentrent souvent sur une seule intervention ou sur une seule population, de sorte qu'il est difficile pour les responsables politiques et les décideurs de synthétiser rapidement les connaissances afin d'éclairer les priorités de financement et les politiques à plus grande échelle. Objectifs: Les objectifs de cette étude étaient (1) de créer une carte présentant les lacunes dans les données probantes en ce qui concerne les interventions pour la douleur chronique chez les enfants et (2) de répertorier les lacunes dans les données probantes existantes par rapport aux priorités de recherche axées sur le patient récemment déterminées. Méthodes: Nous avons effectué une revue systématique des revues systématiques évaluées par des pairs ou des guides de pratique clinique portant sur les interventions en matière de douleur chronique pédiatrique publiés en langue anglaise au cours des 20 dernières années. Des recherches ont été menées dans les bases de données Medline, Embase, PsycINFO, Web of Science, CINAHL et SCOPUS jusqu'au 3 juin 2019 inclusivement. La qualit...

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Systematic Review of the Efficacy and Safety of Gabapentin and Pregabalin for Pain in Children and Adolescents

Abstract: Supplementaltable 1: EMBASE search # Search Statement Results 1 exp gabapentin/ 26338 2 gabapentin.mp. 27266 3 neurontin.mp. 1987 4 exp pregabalin/ 11290 5 pregabalin.mp. 11633 6 lyrica.mp.

Cited by 40 publications

References 35 publications

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion

COVID-19: Pain Management in Patients with SARS-CoV-2 Infection—Molecular Mechanisms, Challenges, and Perspectives

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

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Systematic Review of the Efficacy and Safety of Gabapentin and Pregabalin for Pain in Children and Adolescents

Abstract: Supplementaltable 1: EMBASE search # Search Statement Results 1 exp gabapentin/ 26338 2 gabapentin*.mp. 27266 3 neurontin.mp. 1987 4 exp pregabalin/ 11290 5 pregabalin*.mp. 11633 6 lyrica.mp.

Cited by 40 publications

References 35 publications

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion

Preemptive Pregabalin in Children and Adolescents Undergoing Posterior Instrumented Spinal Fusion

COVID-19: Pain Management in Patients with SARS-CoV-2 Infection—Molecular Mechanisms, Challenges, and Perspectives

Mapping the evidence and gaps of interventions for pediatric chronic pain to inform policy, research, and practice: A systematic review and quality assessment of systematic reviews

Contact Info

Product

Resources

About

Abstract: Supplementaltable 1: EMBASE search # Search Statement Results 1 exp gabapentin/ 26338 2 gabapentin.mp. 27266 3 neurontin.mp. 1987 4 exp pregabalin/ 11290 5 pregabalin.mp. 11633 6 lyrica.mp.