The effects of early neuropathic pain control with gabapentin on long-term chronic pain and itch in burn patients

Model System:

Burn

Reference Type:

Journal article

Accession No.:

J81631

Journal:

Journal of Burn Care And Research (formerly Journal of Burn Care & Rehabilitation)

Year, Volume, Issue, Page(s):

2019 , 40, 4, 457-463

Publication Website:

Abstract:

Study investigated the effect of a neuropathic pain control protocol, as well as early gabapentin initiation (within 72 hours of burn injury), on total inpatient opioid use, chronic pain, and itch. The Burn Model System National Database was used to capture information collected from a single institution for patients over the age of age 14 admitted between 2006 and 2016 with burns. Researchers compared patients who did not receive gabapentin with those who had early gabapentin initiation vs late initiation. They also compared patients who used gabapentin before initiation of a neuropathic pain protocol (February 2015) to those after. Primary outcomes were total inpatient gabapentin, morphine equivalent dose (MED), longitudinal pain and itch, as well as SF-12 Health Survey mental component summary (MCS) and physical component summary (PCS) scores at discharge, 6, 12, and 24 months post injury. Ordinal logistic regression analysis was used to examine pain and itch scores. Linear regression models examined MCS and PCS between groups. Models were adjusted for age, sex, burn size, area grafted, MED, and intensive care unit stay. There was no significant difference in MED with early initiation, yet inpatient gabapentin use increased from 43.9 to 59.5 grams with late initiation. The neuropathic pain protocol did not significantly change total gabapentin use in patients receiving gabapentin but decreased opioid use from 58.1 to 17.4 grams MED. Results suggest that neither early gabapentin nor its use in a standardized neuropathic pain protocol improves long-term pain, itch, PCS, or MCS.

Author(s):