The Effect of Pregabalin and Methylcobalamin Combination on the Chronic Postthoracotomy Pain Syndrome

Metin, Serda Kanbur; Meydan, Burhan; Evman, Serdar; Doğruyol, Talha; Baysungur, Volkan

doi:10.1016/j.athoracsur.2016.09.031

Cited by 8 publications

(5 citation statements)

References 27 publications

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“…Gabapentinoids and antidepressants are first-line treatments for neuropathic pain 177 . In the studies included in this review, gabapentin and pregabalin were shown to effectively reduce chronic sciatica-associated pain 178,179 and overall neuropathic pain 170,175,180 -as previously observed 181,182 . Similarly, amitriptyline was effective in reducing pain associated with painful diabetic neuropathy for up to 2 months 174 -as seen in previous works [183][184][185] .…”

Section: Pharmacological Treatments For Chronic Neuropathic Painmentioning

confidence: 58%

“…First, medical cannabis was shown to relieve pain in patients with overall neuropathic pain and complex regional pain syndrome (CRPS) 186 , despite showing no efficacy in patients with multiple sclerosis 187 , associated with dry mouth and dizziness. The NSAID diclofenac was shown to reduce post-surgical neuropathic pain, for up to 3 months, with heartburn as the most common adverse effect 180 . Finally, the bioflavonoid diosmin 188 , associated with nausea, the protein neublastin 189 , and the anticonvulsant sodium valproate were shown to ameliorate lumbar radicular pain 190 for up to 6 months.…”

Section: Pharmacological Treatments For Chronic Neuropathic Painmentioning

confidence: 99%

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Recent advances in the pharmacological treatment of chronic pain: a systematic review

Fonseca-Rodrigues,

Almeida,

Pinto-Ribeiro

2024

DOR

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Chronic pain is one of the most important public health concerns, greatly impacting the patients' quality of life and with high societal and economical costs. Despite advances in the understanding of pain mechanisms and the establishment of several strategies to decrease pain severity in patients, there continues to be a substantial proportion of patients who are refractory to the currently available treatments. Recently, novel pharmacological strategies have been developed for the treatment/ management of chronic pain, directed at symptoms and psychological complications of the illness. In this work, we performed a systematic review of the recent advances in pharmacological strategies for chronic pain. For that purpose, we searched a total of four databases (PubMed, Science Direct, Web of Science, and Scopus) for clinical trials testing drugs in patients with chronic pain, completed between the years 2017 and 2021 (1 st January 2017 up to 17 th November 2021). The different treatments were analysed and compared regarding their effectiveness, indications, and side effects. We included 166 studies, which provided information on 46 796 participants, mostly women (64%). This review pools together data on novel drug therapeutic strategies or improved applications of already known drugs, from opioids to monoclonal antibodies, providing researchers and health professionals with tools to ameliorate human chronic pain research and management.

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Section: Pharmacological Treatments For Chronic Neuropathic Painmentioning

confidence: 58%

Section: Pharmacological Treatments For Chronic Neuropathic Painmentioning

confidence: 99%

Recent advances in the pharmacological treatment of chronic pain: a systematic review

Fonseca-Rodrigues,

Almeida,

Pinto-Ribeiro

2024

DOR

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“…The literature search included 9 qualifying RCTs with 684 patients that met inclusion criteria (Figure 1). 15–23 Quality assessment of RCTs was presented in Figures 2 and 3. The characteristics of patients and interventions are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Three hundred forty-four patients were in the pregabalin group and 340 were in the control group 15,20,21. Two different dosages of pregabalin 150 mg16–19,21,22 or 300 mg15,20,23 were administered to patients orally every day. The administration period was from 1 to 90 days.…”

Section: Resultsmentioning

confidence: 99%

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

Liu²,

Zeng

et al. 2018

JPR

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PurposePregabalin is commonly used as an analgesic for neuropathic pain. But pregabalin as an adjunct to a multimodal analgesic regimen – although standard clinical protocol in some settings – has remained controversial. This meta-analysis was conducted to identify the efficacy of pregabalin for management of postoperative pain in thoracotomy.Materials and methodsPubmed, Embase, Cochrane, Web of Science, Springer, and Clinical Trial Register database were searched for randomized controlled trials (RCTs) of pregabalin in preventing postoperative pain in thoracotomy. Review Manager 5.3 and STATA 12.0 were selected to conduct the meta-analysis. Trial sequential analysis was used to control random errors and calculate the required information size.ResultsNine RCTs with 684 patients were included in our meta-analysis. Outcomes favoring pregabalin included less pain on a 0–10 scale on 1 day [mean difference (MD): −0.87; 95% CI: −1.55 to −0.19; P=0.01], 3 days (MD: −1.55; 95% CI: −1.93 to −1.18; P<0.00001), 1 month (MD: −1.58; 95% CI: −2.75 to −0.42; P=0.008), 3 months (MD: −1.69; 95% CI: −2.71 to −0.66; P=0.001) postoperatively, and less incidence of neuropathic pain (OR: 0.20; 95% CI: 0.05–0.91; P=0.04), less mean morphine consumption (MD: −5.03; 95% CI: −8.06 to −1.99; P=0.001), but more dizziness (OR: 3.33; 95% CI: 1.36–8.17; P=0.009), more drowsiness (OR: 8.61; 95% CI: 2.23–33.20; P=0.002), and less constipation (OR: 0.23; 95% CI: 0.09–0.59; P=0.002). There was no statistical differences in pain score on 7 days (MD:–0.77; 95% CI: −2.38 to 0.84; P=0.35), nausea (OR: 0.73; 95% CI: 0.42–1.26; P=0.26), and vomiting (OR: 0.83; 95% CI: 0.36–1.90; P=0.65).ConclusionPregabalin can prevent postoperative pain in thoracotomy and decrease incidence of neuropathic pain and morphine consumption. Pregabalin may be a valuable asset in management of acute and persistent postoperative pain in thoracotomy.

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“…Cobalamin promotes myelination and transport of the axonal cytoskeleton and regenerates peripheral nerves 20 . Methylcobalamin has potential analgesic effects in experimental and clinical studies 21–23 . According to guidelines, topical treatment should be considered in the management of localized neuropathic pain 24 .…”

Section: Introductionmentioning

confidence: 99%

Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

et al. 2020

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Objectives: The ophthalmic branch of the trigeminal nerve is one of the most frequently involved sites of postherpetic neuralgia. A single-center randomized controlled study was conducted to evaluate the efficacy of local methylcobalamin injection for subacute ophthalmic herpetic neuralgia (SOHN). Methods: One hundred and five patients with a pain score of 4 or greater were randomized to receive a combination of methylcobalamin and lidocaine via local injection (LM group, n = 35), intramuscular methylcobalamin and local lidocaine injection (IM group, n = 35), and oral methylcobalamin tablet and lidocaine local injection (OM group, n = 35) for 4 weeks. Multilevel mixed modeling was employed to examine treatment responses. Results: Pain scores were reduced in all groups, but this reduction was significantly greater in the LM group (6.7 at baseline vs. 2.8 at endpoint) when compared with systemic administration (IM group 6.8 vs. 4.9, OM group 6.7 vs. 5.1). Clinically relevant reduction of pain (>30%) was seen in 91% of patients in the LM group, a significantly greater proportion than in the systemic groups (66% IM group, 57% OM group). Analgesic use reduced significantly in the LM group (94% at baseline vs. 6% at endpoint) but not in systemic groups (IM group 97% vs. 86%, OM group 94% vs. 80%). Health-related quality of life was higher in the LM group than in the systemic groups. In mixed modelling, increased age was associated with a lower response to methylcobalamin. Conclusions: This study indicates that local injection of methylcobalamin produces significant pain relief from SOHN and is superior to systemic administration. &

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The Effect of Pregabalin and Methylcobalamin Combination on the Chronic Postthoracotomy Pain Syndrome

Cited by 8 publications

References 27 publications

Recent advances in the pharmacological treatment of chronic pain: a systematic review

Recent advances in the pharmacological treatment of chronic pain: a systematic review

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

Local Administration of Methylcobalamin for Subacute Ophthalmic Herpetic Neuralgia: A Randomized, Phase III Clinical Trial

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