Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury

A retrospective chart review

Isha Kaul, Ami Amin, Marta Rosenberg, Laura Rosenberg, Walter Meyer

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction: Pruritis after burn is one of the most common chronic complaints in burn survivors. Pruritus is often indistinguishable from neuropathic pain. There is a paucity of studies reporting the use of gabapentin and pregabalin to treat both pruritus and neuropathic pain. The purpose of this current study is to explore and document the effect of gabapentin and pregabalin in children and adolescent burn survivors. Methods: A retrospective review of charts and pharmacy records of gabapentin and pregabalin dispensed to control pruritus and/or pain was conducted for burn survivors up to 20 years of age. Data collected included medication doses, age and weight of patients, presence of neuropathic pain and pruritus, reported response to medication, and side effects of these medications. 136 individuals who received gabapentin, pregabalin, or both medications are included in the study. 112 received only gabapentin, none received only pregabalin, and 24 received both. All results are documented in mean. ±. standard deviation (s.d.) dose/kg/day. 104 individuals experienced pruritus exclusively, two experienced neuropathic pain exclusively, and 30 experienced both. Use of medications was considered effective if the individuals reported pruritus or pain relief from the medication. The medication was considered safe if the individuals did not experience adverse side effects warranting discontinuation of the drugs. Medications were continued with dose adjustments if an individual reported minor side effects such as sedation or hyperactivity. Results: The average effective dose mg/kg/day for gabapentin and pregabalin was calculated for each of the three age groups (≤5. years, 6-12 years, and >12. years). The average effective dose of gabapentin was 23.9. ±. 10.3. mg/kg/day for children ≤5. years, 27.0. ±. 15.3. mg/kg/day for children 6-12 years, and 34.1. ±. 15.7. mg/kg/day for children >12. years. The average effective dose of pregabalin was 6.5. ±. 3.5. mg/kg/day for children 6-12 years and 4.7. ±. 1.6. mg/kg/day for children >12. years. One 5-year-old child received 3.7. mg/kg/day of pregabalin. Note that for all patients in this study, pregabalin was added after an inadequate response to gabapentin. For individuals receiving both gabapentin and pregabalin, the maximum gabapentin failure dose for pruritus was 32.8. ±. 18.0. mg/kg/day and for both pain and pruritus was 28.1. ±. 18.3. mg/kg/day. For individuals treated with only gabapentin, 91.4% had an adequate response for pruritus, 100% for neuropathic pain, and 43.3% for both pruritus and pain. 100% of individuals treated with both gabapentin and pregabalin had an adequate response for pruritus and 88.2% had an adequate response for both pruritus and pain. Gabapentin was associated with hyperactivity in two individuals, and sedation in one individual. One individual reported nausea, vomiting, and headaches when taking both medications; this resolved when gabapentin was discontinued. One individual reported sedation while taking both medications. Conclusion: Gabapentin and pregabalin are effective in relieving pruritus and neuropathic pain in most burn survivors. In some instances, these medications can be given together. Few individuals reported side effects.

Original languageEnglish (US)
JournalBurns
DOIs
StateAccepted/In press - 2017

Fingerprint

Neuralgia
Pruritus
Wounds and Injuries
Survivors
Pain
gabapentin
Pregabalin
Social Adjustment
Nausea
Vomiting
Headache

Keywords

  • Burns
  • Children
  • Gabapentin
  • Neuropathic pain
  • Pregabalin
  • Pruritus

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury : A retrospective chart review. / Kaul, Isha; Amin, Ami; Rosenberg, Marta; Rosenberg, Laura; Meyer, Walter.

In: Burns, 2017.

Research output: Contribution to journalArticle

Kaul, Isha ; Amin, Ami ; Rosenberg, Marta ; Rosenberg, Laura ; Meyer, Walter. / Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury : A retrospective chart review. In: Burns. 2017.
@article{2a497e3e14014ba5bf98a8e11793fc95,
title = "Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury: A retrospective chart review",
abstract = "Introduction: Pruritis after burn is one of the most common chronic complaints in burn survivors. Pruritus is often indistinguishable from neuropathic pain. There is a paucity of studies reporting the use of gabapentin and pregabalin to treat both pruritus and neuropathic pain. The purpose of this current study is to explore and document the effect of gabapentin and pregabalin in children and adolescent burn survivors. Methods: A retrospective review of charts and pharmacy records of gabapentin and pregabalin dispensed to control pruritus and/or pain was conducted for burn survivors up to 20 years of age. Data collected included medication doses, age and weight of patients, presence of neuropathic pain and pruritus, reported response to medication, and side effects of these medications. 136 individuals who received gabapentin, pregabalin, or both medications are included in the study. 112 received only gabapentin, none received only pregabalin, and 24 received both. All results are documented in mean. ±. standard deviation (s.d.) dose/kg/day. 104 individuals experienced pruritus exclusively, two experienced neuropathic pain exclusively, and 30 experienced both. Use of medications was considered effective if the individuals reported pruritus or pain relief from the medication. The medication was considered safe if the individuals did not experience adverse side effects warranting discontinuation of the drugs. Medications were continued with dose adjustments if an individual reported minor side effects such as sedation or hyperactivity. Results: The average effective dose mg/kg/day for gabapentin and pregabalin was calculated for each of the three age groups (≤5. years, 6-12 years, and >12. years). The average effective dose of gabapentin was 23.9. ±. 10.3. mg/kg/day for children ≤5. years, 27.0. ±. 15.3. mg/kg/day for children 6-12 years, and 34.1. ±. 15.7. mg/kg/day for children >12. years. The average effective dose of pregabalin was 6.5. ±. 3.5. mg/kg/day for children 6-12 years and 4.7. ±. 1.6. mg/kg/day for children >12. years. One 5-year-old child received 3.7. mg/kg/day of pregabalin. Note that for all patients in this study, pregabalin was added after an inadequate response to gabapentin. For individuals receiving both gabapentin and pregabalin, the maximum gabapentin failure dose for pruritus was 32.8. ±. 18.0. mg/kg/day and for both pain and pruritus was 28.1. ±. 18.3. mg/kg/day. For individuals treated with only gabapentin, 91.4{\%} had an adequate response for pruritus, 100{\%} for neuropathic pain, and 43.3{\%} for both pruritus and pain. 100{\%} of individuals treated with both gabapentin and pregabalin had an adequate response for pruritus and 88.2{\%} had an adequate response for both pruritus and pain. Gabapentin was associated with hyperactivity in two individuals, and sedation in one individual. One individual reported nausea, vomiting, and headaches when taking both medications; this resolved when gabapentin was discontinued. One individual reported sedation while taking both medications. Conclusion: Gabapentin and pregabalin are effective in relieving pruritus and neuropathic pain in most burn survivors. In some instances, these medications can be given together. Few individuals reported side effects.",
keywords = "Burns, Children, Gabapentin, Neuropathic pain, Pregabalin, Pruritus",
author = "Isha Kaul and Ami Amin and Marta Rosenberg and Laura Rosenberg and Walter Meyer",
year = "2017",
doi = "10.1016/j.burns.2017.07.018",
language = "English (US)",
journal = "Burns",
issn = "0305-4179",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury

T2 - A retrospective chart review

AU - Kaul, Isha

AU - Amin, Ami

AU - Rosenberg, Marta

AU - Rosenberg, Laura

AU - Meyer, Walter

PY - 2017

Y1 - 2017

N2 - Introduction: Pruritis after burn is one of the most common chronic complaints in burn survivors. Pruritus is often indistinguishable from neuropathic pain. There is a paucity of studies reporting the use of gabapentin and pregabalin to treat both pruritus and neuropathic pain. The purpose of this current study is to explore and document the effect of gabapentin and pregabalin in children and adolescent burn survivors. Methods: A retrospective review of charts and pharmacy records of gabapentin and pregabalin dispensed to control pruritus and/or pain was conducted for burn survivors up to 20 years of age. Data collected included medication doses, age and weight of patients, presence of neuropathic pain and pruritus, reported response to medication, and side effects of these medications. 136 individuals who received gabapentin, pregabalin, or both medications are included in the study. 112 received only gabapentin, none received only pregabalin, and 24 received both. All results are documented in mean. ±. standard deviation (s.d.) dose/kg/day. 104 individuals experienced pruritus exclusively, two experienced neuropathic pain exclusively, and 30 experienced both. Use of medications was considered effective if the individuals reported pruritus or pain relief from the medication. The medication was considered safe if the individuals did not experience adverse side effects warranting discontinuation of the drugs. Medications were continued with dose adjustments if an individual reported minor side effects such as sedation or hyperactivity. Results: The average effective dose mg/kg/day for gabapentin and pregabalin was calculated for each of the three age groups (≤5. years, 6-12 years, and >12. years). The average effective dose of gabapentin was 23.9. ±. 10.3. mg/kg/day for children ≤5. years, 27.0. ±. 15.3. mg/kg/day for children 6-12 years, and 34.1. ±. 15.7. mg/kg/day for children >12. years. The average effective dose of pregabalin was 6.5. ±. 3.5. mg/kg/day for children 6-12 years and 4.7. ±. 1.6. mg/kg/day for children >12. years. One 5-year-old child received 3.7. mg/kg/day of pregabalin. Note that for all patients in this study, pregabalin was added after an inadequate response to gabapentin. For individuals receiving both gabapentin and pregabalin, the maximum gabapentin failure dose for pruritus was 32.8. ±. 18.0. mg/kg/day and for both pain and pruritus was 28.1. ±. 18.3. mg/kg/day. For individuals treated with only gabapentin, 91.4% had an adequate response for pruritus, 100% for neuropathic pain, and 43.3% for both pruritus and pain. 100% of individuals treated with both gabapentin and pregabalin had an adequate response for pruritus and 88.2% had an adequate response for both pruritus and pain. Gabapentin was associated with hyperactivity in two individuals, and sedation in one individual. One individual reported nausea, vomiting, and headaches when taking both medications; this resolved when gabapentin was discontinued. One individual reported sedation while taking both medications. Conclusion: Gabapentin and pregabalin are effective in relieving pruritus and neuropathic pain in most burn survivors. In some instances, these medications can be given together. Few individuals reported side effects.

AB - Introduction: Pruritis after burn is one of the most common chronic complaints in burn survivors. Pruritus is often indistinguishable from neuropathic pain. There is a paucity of studies reporting the use of gabapentin and pregabalin to treat both pruritus and neuropathic pain. The purpose of this current study is to explore and document the effect of gabapentin and pregabalin in children and adolescent burn survivors. Methods: A retrospective review of charts and pharmacy records of gabapentin and pregabalin dispensed to control pruritus and/or pain was conducted for burn survivors up to 20 years of age. Data collected included medication doses, age and weight of patients, presence of neuropathic pain and pruritus, reported response to medication, and side effects of these medications. 136 individuals who received gabapentin, pregabalin, or both medications are included in the study. 112 received only gabapentin, none received only pregabalin, and 24 received both. All results are documented in mean. ±. standard deviation (s.d.) dose/kg/day. 104 individuals experienced pruritus exclusively, two experienced neuropathic pain exclusively, and 30 experienced both. Use of medications was considered effective if the individuals reported pruritus or pain relief from the medication. The medication was considered safe if the individuals did not experience adverse side effects warranting discontinuation of the drugs. Medications were continued with dose adjustments if an individual reported minor side effects such as sedation or hyperactivity. Results: The average effective dose mg/kg/day for gabapentin and pregabalin was calculated for each of the three age groups (≤5. years, 6-12 years, and >12. years). The average effective dose of gabapentin was 23.9. ±. 10.3. mg/kg/day for children ≤5. years, 27.0. ±. 15.3. mg/kg/day for children 6-12 years, and 34.1. ±. 15.7. mg/kg/day for children >12. years. The average effective dose of pregabalin was 6.5. ±. 3.5. mg/kg/day for children 6-12 years and 4.7. ±. 1.6. mg/kg/day for children >12. years. One 5-year-old child received 3.7. mg/kg/day of pregabalin. Note that for all patients in this study, pregabalin was added after an inadequate response to gabapentin. For individuals receiving both gabapentin and pregabalin, the maximum gabapentin failure dose for pruritus was 32.8. ±. 18.0. mg/kg/day and for both pain and pruritus was 28.1. ±. 18.3. mg/kg/day. For individuals treated with only gabapentin, 91.4% had an adequate response for pruritus, 100% for neuropathic pain, and 43.3% for both pruritus and pain. 100% of individuals treated with both gabapentin and pregabalin had an adequate response for pruritus and 88.2% had an adequate response for both pruritus and pain. Gabapentin was associated with hyperactivity in two individuals, and sedation in one individual. One individual reported nausea, vomiting, and headaches when taking both medications; this resolved when gabapentin was discontinued. One individual reported sedation while taking both medications. Conclusion: Gabapentin and pregabalin are effective in relieving pruritus and neuropathic pain in most burn survivors. In some instances, these medications can be given together. Few individuals reported side effects.

KW - Burns

KW - Children

KW - Gabapentin

KW - Neuropathic pain

KW - Pregabalin

KW - Pruritus

UR - http://www.scopus.com/inward/record.url?scp=85027414601&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027414601&partnerID=8YFLogxK

U2 - 10.1016/j.burns.2017.07.018

DO - 10.1016/j.burns.2017.07.018

M3 - Article

JO - Burns

JF - Burns

SN - 0305-4179

ER -