Dosis de gabapentoides en manejo del dolor neuropático en pacientes de la Unidad de Dolor y Cuidados Paliativos del Hospital Clínico de la Universidad de Chile: Publicado en Revista El Dolor 2009;51:10-16

Juan Pablo Miranda; Leonella Jiménez; Rodrigo Orellana; Nancy Abusada; Tomás Maiza; Marcos Telias; Andrés Otárola; Juanita Jaque

doi:10.47924/neurotarget2013270

Authors

Juan Pablo Miranda Pain and Palliative Care Unit. Department of Internal Medicine. University of Chile Clinical Hospital.
Leonella Jiménez Anatomy and Developmental Biology Program. faculty of Medicine. University of Chile.
Rodrigo Orellana Pharmacy service. University of Chile Clinical Hospital.
Nancy Abusada Pharmacy service. University of Chile Clinical Hospital.
Tomás Maiza Medicine student. School of Medicine. University of Chile.
Marcos Telias Medicine student. School of Medicine. University of Chile.
Andrés Otárola Medicine student. School of Medicine. University of Chile.
Juanita Jaque Pain and Palliative Care Unit. Department of Internal Medicine. University of Chile Clinical Hospital.

DOI:

https://doi.org/10.47924/neurotarget2013270

Keywords:

Pain, Gabapentin, Pregabalin

Abstract

Objective: To determine the dose of gabapentoids to has to be used to manage neuropathic pain in outpatients undergoing treatment at the Pain and Palliative Care Unit of Universidad de Chile Hospital.
Materials: A descriptive prospective study of outpatients of the Pain and Palliative Care Unit diagnosed with neuropathic pain was conducted within a period of time starting March 2008 through February 2009. Subsequently, demographic, clinical, and drug therapy variables were analyzed, defining as analgesia efficiency the reduction of pain intensity according to the visual analogue scale, a reduced DN4 questionnaire score, functionality in Karnofky scale, and improve ments in terms of insomnia. Analysis was made using Student and Wilcoxon tests for paired data in statistical program Stata 10.0 ®, with a significant p value <0,05.
Results: A total 96 patients were studied within the term mentioned above. From this total, 86 (89.6%) patients complied with a definitive neuropathic pain criterion and full records, which were the final sample of this study. No significant differences per gender were found among the 62 (72.1%) female patients whose average age was 55.3±14.8 (28 - 84) and the 24 (27.9%) male patients whose average age was
54.8±19.3 (18 - 84). The main diagnoses were lumbago (16%) and fibromyalgia (16%), but no differences per gender were found. The final doses determined after using gabapentoids were 693.3±367.4 mg. for gabapentin and 168.8±87.3 for pregabalin. In connection with the instruments applied, the intensity of pain scored according to EVA scale and DN4 scale were significantly reduced (p<0.01) in 61.1% (7.2 v/s 2.8) and 68.9% (5.8 v/s 1.8), respectively (Figures 1 and 2). Severe insomnia was reduced from 76 to 8% p<0.001 and no significant score differences in Karnofsky functionality scale were found.
Discussion: Gabapentoids along with analgesia based on the analgesic scale model offer us a new and effective tool to relieve pain in patients diagnosed with neuropathic pain. This is the reason gabapentoids should be regarded as first line drugs to help patients with neuropathic pain.

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