The Analgesic Effect of Gabapentin and Mexiletine After Breast Surgery for Cancer

Fassoulaki, Argyro; Patris, Konstantinos; Sarantopoulos, Constantine; Hogan, Quinn H.

doi:10.1097/00000539-200210000-00036

Cited by 139 publications

(110 citation statements)

References 11 publications

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“…The surgical procedures were abdominal hysterectomy in five studies [27-31], spinal surgery in four studies [24,32-34], breast surgery in two studies [35,36] and a variety of different surgical procedures in the remaining twelve studies [25,26,37-46]. Median number of patients included in the studies was 50 (range 40 – 306).…”

Section: Resultsmentioning

confidence: 99%

Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure

2007

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Section: Resultsmentioning

confidence: 99%

Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure

2007

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“…This may require days or even weeks of titration to target dosage with such medications as duloxetine, gabapentin, or pregabalin. Many prevention studies for CPSP have initiated gabapentin and other oral medications between 1 hour and 1 day prior to surgery [3,12,24,25,27,33,51,52,57,66,95,97,98,101,108,116,131,133,147,148,165]. One study initiated treatment with an antidepressant 2-3 weeks prior to coronary artery bypass surgery; however, chronic pain was only assessed as part of a composite quality of life measure [31].…”

Section: Design Considerations In the Context Of 4 Illustrative Prmentioning

confidence: 99%

“…We suggest that the time period in which post-surgical pain is considered acute should be based on natural history data specific to each surgery model or, in the absence of epidemiological data, the clinical expertise of the investigator. Several clinical trials have extended the investigational treatment between 5 and 14 days post-surgery [3,27,51,52,67,66,95,108,120,133]. …”

Section: Design Considerations In the Context Of 4 Illustrative Prmentioning

confidence: 99%

Research design considerations for chronic pain prevention clinical trials

Gewandter

Dworkin

Turk

et al. 2015

Pain

130

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Although certain risk factors can identify individuals who are most likely to develop chronic pain, few interventions to prevent chronic pain have been identified. To facilitate the identification of preventive interventions, an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain. We present general design considerations for prevention trials in populations that are at relatively high risk for developing chronic pain. Specific design considerations included subject identification, timing and duration of treatment, outcomes, timing of assessment, and adjusting for risk factors in the analyses. We provide a detailed examination of 4 models of chronic pain prevention (i.e., chronic post-surgical pain, postherpetic neuralgia, chronic low back pain, and painful chemotherapy-induced peripheral neuropathy). The issues discussed can, in many instances, be extrapolated to other chronic pain conditions. These examples were selected because they are representative models of primary and secondary prevention, reflect persistent pain resulting from multiple insults (i.e., surgery, viral infection, injury, and toxic/noxious element exposure), and are chronically painful conditions that are treated with a range of interventions. Improvements in the design of chronic pain prevention trials could improve assay sensitivity and thus accelerate the identification of efficacious interventions. Such interventions would have the potential to reduce the prevalence of chronic pain in the population. Additionally, standardization of outcomes in prevention clinical trials will facilitate meta-analyses and systematic reviews and improve detection of preventive strategies emerging from clinical trials.

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“…71,89 The use of adjuvant analgesics (eg, antiarrhythmics, anticonvulsants, antidepressants, and NMDA receptor blockers) to decrease acute pain and prevent chronic pain has not been well studied. Fassoulaki et al 90 noted that either gabapentin or mexiletine decreased acute postoperative analgesic use after mastectomy, and burning pain at 3 months was decreased. Venlafaxine did not significantly alter either postoperative pain at rest or analgesic consumption after mastectomy, but pain with movement was decreased; at 6 months, the prevalence of pain was significantly less in the venlafaxine group.…”

Section: Literature Searchmentioning

confidence: 99%

Acute Post-Surgical Pain Management: A Critical Appraisal of Current Practice

Rathmell

Sinatra

et al. 2006

Regional Anesthesia and Pain Medicine

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The Acute Pain Summit 2005 was convened to critically examine the perceptions of physicians about current methods used to control postoperative pain and to compare those perceptions with the available scientific evidence. Clinicians with expertise in treatment of postsurgical pain were asked to evaluate 10 practice-based statements. The statements were written to reflect areas within the field of acute-pain management, where significant questions remain regarding everyday practice. Each statement made a specific claim about the usefulness of a specific therapy (eg, PCA or epidural analgesia) or the use of pain-control modalities in specific patient populations (eg, epidural analgesia after colon resection). Members of the American Society of Regional Anesthesia and Pain Medicine (ASRA) were asked, via a Web-based survey, to rate their degree of agreement with each of the 10 statements; 22.8% (n = 632) of members responded. In preparation for the pain summit, a panel member independently conducted a literature search and summarized the available evidence relevant to each statement. Summit participants convened in December 2005. The assigned panel member presented the available evidence, and workshop participants then assigned a category for the level of evidence and recommendation for each statement. All participants then voted about each statement by use of the same accept/reject scale used earlier by ASRA members. This manuscript details those opinions and presents a critical analysis of the existing evidence supporting new and emerging techniques used to control postsurgical pain.

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The Analgesic Effect of Gabapentin and Mexiletine After Breast Surgery for Cancer

Cited by 139 publications

References 11 publications

Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure

Gabapentin and postoperative pain: a qualitative and quantitative systematic review, with focus on procedure

Research design considerations for chronic pain prevention clinical trials

Acute Post-Surgical Pain Management: A Critical Appraisal of Current Practice

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