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One of the most common complaints showed by the burn survivors is the pruritis afterburn.
Children recovering from burn injury often have a longterm complaint of pruritus. Pruritus is usually identical to neuropathic pain. But very few of the studies reporting the use of gabapentin and pregabalin to treat both pruritus and neuropathic pain with inconsistent results. Therefore in the present study, the author revealed that gabapentin and pregabalin are effective in relieving pruritus and neuropathic pain in most burn survivors.
One of the most common complaints showed by the burn survivors is the pruritis afterburn. Pruritus is usually indistinct from neuropathic pain and the evidence regarding Pregabalin and Gabapentin ability to manage pruritus and neuropathic pain is also insufficient. This present investigation intends to investigate and record the impact of Pregabalin and Gabapentin among children and adolescent burn survivors.
A retrospective review of pharmacy records and charts of Pregabalin and Gabapentin administered to control pain and/or pruritus was performed and collected the data regarding age and weight of patients, the presence of neuropathic pain and pruritus, medication doses, reported response to medication, and medications adverse events. A total of one hundred thirty-six participants who took Pregabalin/Gabapentin alone or the combination are selected for the analysis. No participant received Pregabalin, 102 obtained Gabapentin and 24 took both medications. All the outcomes are recorded in the mean ± standard deviation (s.d.) dose/kg/day. A total of 30 patients experienced both the manifestations, 104 experienced pruritus particularly, and two experienced neuropathic pain exclusively. The provided medicine considered to be useful if the participants reported pruritus or pain relief from the medicine. The medicine was deemed to be safe if the subjects did not endure adverse side effects assuring discontinuation of the medications. However, if a person showed minor side effects such as hyperactivity or sedation, medicines were not stopped and were resumed with dose adjustments.
Each group is evaluated to measure the average effective dose mg/kg/day for Pregabalin and Gabapentin. The children of ≤5 years old, 6–12 years old and >12 years showed 23.9 ± 10.3, 27.0 ± 15.3, and 34.1 ±15.7 mg/kg/day average effective dose of Gabapentin, respectively. Further, the children of 6–12 years old and >12 years old exhibited 6.5 ± 3.5 and 4.7 ± 1.6 mg/kg/day average effective dose of Pregabalin, respectively. One 5-year-old child obtained 3.7 mg/kg/day of Pregabalin. The patients of this study received Pregabalin after the ineffectual response to Gabapentin. The maximum Gabapentin failure dose for both pain and pruritus among the subjects who obtained both the medications was 28.1 ± 18.3 mg/kg/day and for pruritus was 32.8 ± 18.0 mg/kg/day. The subjects obtained Gabapentin exhibited 100% adequate response for neuropathic pain, 91.4% for pruritus, and 43.3% for both pruritus and pain. Hundred per cent of participants employed with both Pregabalin and Gabapentin had a satisfactory response for pruritus, and 88.2% had a satisfactory response for both pain and pruritus. Two out of three subjects who received Gabapentin showed hyperactivity and one showed sedation. The patients who took both medications exhibited the cases of nausea, vomiting, and headaches and fixed after the Gabapentin discontinuation. One person described sedation while receiving both medications.
Pregabalin and Gabapentin are efficient in reducing pruritus and neuropathic pain in the maximum of burn survivors. In some cases, these medicines can be delivered concurrently. Some participants presented side effects.
Burns 2018;44(2): 414-422
Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury: A retrospective chart review
Isha Kaul et al.
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