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Gabapentin for acute and chronic pain
P J Wiffen1, H J McQuay, J E Edwards
1Pain Research Unit, Churchill Hospital, Old Road, Headington, Oxford, UK, OX3 7LJ. phil.wiffen@pru.ox.ac.uk
The Cochrane Database of Systematic Reviews
|July 22, 2005
Summary
Gabapentin is effective for chronic neuropathic pain, including diabetic neuropathy and post-herpetic neuralgia. However, evidence suggests it is not effective for acute pain management.
Area of Science:
- Pharmacology
- Neurology
- Pain Management
Background:
- Anticonvulsant drugs have been utilized for pain management since the 1960s.
- Clinical observations suggest efficacy in chronic neuropathic pain, particularly lancinating or burning pain.
Purpose of the Study:
- To evaluate the analgesic effectiveness of gabapentin for pain management.
- To assess the adverse effects associated with gabapentin use in clinical practice.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through MEDLINE, EMBASE, SIGLE, and CENTRAL databases.
- Data extraction and quality scoring by two independent reviewers.
- Calculation of Numbers-Needed-to-Treat (NNTs) for effectiveness and adverse events.
Main Results:
- Fifteen RCTs involving 1468 participants were analyzed, focusing on various pain conditions.
- Gabapentin showed effectiveness in chronic neuropathic pain (NNT=4.3), with 42% of participants improving versus 19% on placebo.
- Specific NNTs for diabetic neuropathy (2.9) and post-herpetic neuralgia (3.9) were reported. No significant benefit was observed in acute post-operative pain.
Conclusions:
- Gabapentin demonstrates efficacy in treating chronic neuropathic pain conditions.
- Limited evidence indicates gabapentin is ineffective for acute pain.
- The number needed to harm for adverse events leading to withdrawal was not significant.