Gabapentin and pregabalin for chronic neuropathic and early postsurgical pain: current evidence and future directions
Gabapentin and pregabalin for chronic neuropathic and early postsurgical pain: current evidence and future directions
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DOI：
10.1097/aco.0b013e3282effaa7
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发表时间：
2007-10-01
影响因子：
2.5
通讯作者：
Gilron, Ian
中科院分区：
文献类型：
--
作者：
Gilron, Ian
综述目的加巴喷丁和普瑞巴林与α 2-δ钙通道亚单位结合，是一类新型镇痛药物。支持其用于慢性神经性疼痛和早期术后疼痛的证据基础review.Recent findingsMultiple，large，high-quality trials已经证明了加巴喷丁和普瑞巴林在神经性疼痛中的安全性和有效性。治疗相关的疼痛和睡眠改善对生活质量有积极影响。然而，镇静、头晕和共济失调是重要且相对常见的不良反应。越来越多的证据表明，加巴喷丁（可能还有普瑞巴林）在手术后也发挥重要作用。多项高质量的试验已经证明了加巴喷丁在各种外科手术后的镇痛和阿片类药物节省疗效。加巴喷丁和普瑞巴林减少运动诱发的疼痛，这可以导致增强功能术后恢复。术后阿片类药物保留的相关性值得怀疑，因为很少有试验显示阿片类药物相关不良反应减少。仅在少数试验中报告了镇静、头晕和共济失调。未来更大规模的围手术期试验集中在安全性评估是必要的，however.SummaryGabapentin和普瑞巴林是有效的治疗神经性疼痛和术后疼痛。解决几个具体问题的未来研究将有助于更好地描述它们在治疗这些和其他疼痛疾病中的最佳作用。
Purpose of reviewGabapentin and pregabalin bind to the alpha-2-delta calcium channel subunit and represent a novel analgesic drug class. The evidence base supporting their use for chronic neuropathic and early postsurgical pain is reviewed.Recent findingsMultiple, large, high-quality trials have demonstrated the safety and efficacy of gabapentin and pregabalin in neuropathic pain. Treatment-related improvement of pain and sleep positively impact upon quality of life. Sedation, dizziness and ataxia are important and relatively common adverse effects, however. Accumulating evidence indicates that gabapentin, and possibly pregabalin, also exert important effects following surgery. Multiple high-quality trials have demonstrated analgesic and opioid-sparing efficacy with gabapentin following various surgical procedures. Gabapentin and pregabalin reduce movement-evoked pain and this can lead to enhanced functional postoperative recovery. Postoperative opioid sparing is of questionable relevance since few trials have shown reduced opioid-related adverse effects. Sedation, dizziness and ataxia have been reported in only a few trials. Future larger-scale perioperative trials focused on safety assessment are needed, however.SummaryGabapentin and pregabalin are efficacious treatments for neuropathic and postsurgical pain. Future research addressing several specific questions would serve to better delineate their optimal roles in treating these and other pain conditions.