Effects of gabapentin on the different components of peripheral and central neuropathic pain syndromes: A pilot study
Effects of gabapentin on the different components of peripheral and central neuropathic pain syndromes: A pilot study
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DOI：
10.1159/000007979
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发表时间：
1998-01-01
影响因子：
2.4
通讯作者：
Bouhassira, D
中科院分区：
文献类型：
--
作者：
Attal, N;Brasseur, L;Bouhassira, D
抗惊厥药被广泛用于神经病理性疼痛的治疗，并被认为优先作用于抽搐、射击疼痛。本研究系统地评价了新型抗惊厥药加巴喷丁对18例周围神经损伤或中枢损害患者的自发性疼痛和诱发性疼痛的疗效。口服加巴喷丁的剂量逐渐增加，最高可达2400毫克/天。在研究开始时(基线)和达到稳定剂量后6周，对自发的持续性和阵发性疼痛、超敏和痛觉过敏进行评估。定量感觉测试被用来测量对机械和热刺激的检测和痛阈值，以及对阈值以上刺激的反应。加巴喷丁对持续性自发性疼痛有中度和统计学意义上的缓解作用，在减轻阵发性疼痛方面特别有效。一个令人惊讶的发现是对刷牙引起的痛觉过敏和冷痛有显著效果。相比之下，对静态、机械和热刺激的检测和痛阈值没有观察到影响。副作用一般很小，不会干扰日常活动。本研究提示加巴喷丁具有优先的止痛和/或止痛作用，对周围神经损伤和中枢损害引起的疼痛同样有效。
Anticonvulsants are widely used in the treatment of neuropathic pain, and are assumed to act preferentially on lancinating, shooting pain. In the present study, the effects of gabapentin, a novel anticonvulsant, were evaluated systematically on both spontaneous and evoked pain in 18 patients with peripheral nerve injuries or central lesions. Gabapentin was administered orally in gradually increasing doses up to a maximum of 2,400 mg/day. Evaluations of spontaneous ongoing and paroxysmal pain, allodynia and hyperalgesia were performed at the beginning of the study ('baseline') and 6 weeks after the steady-state dose had been reached. Quantitative sensory tests were used to measure detection and pain thresholds to mechanical and thermal stimuli and the responses to suprathreshold stimuli. Gabapentin induced a moderate and statistically significant relief of ongoing spontaneous pain and was particularly effective in reducing paroxysmal pain. A striking finding was the significant effect on brush-induced and cold allodynia. In contrast, no effects were observed on detection and pain thresholds to static mechanical and hot stimuli. Side effects were generally minor and did not interfere with everyday activities. The present study suggests that gabapentin has preferential antihyperalgesic and/or antiallodynic effects, and is equally effective in pain due to peripheral nerve injuries and central lesions.