Treatment of post-burn neuropathic pain: evaluation of pregablin

Burn survivors have described a type of pain, usually after wound healing, that has characteristics of neuropathic pain. This pain is not well treated with conventional medications. Pregabalin has had reported success in treating diabetic and post-herpetic neuropathic pain. We report our experience with pregabalin for the treatment of post-burn neuropathic pain. A retrospective review of patients treated with pregabalin in a burn outpatient clinic was undertaken. A numerical pain scale was administered to each patient prior to and after treatment to determine efficacy. Side effects and reasons for discontinuation were noted. Out of 24 patients 4 patients were lost to followup, 5 patients discontinued taking pregabalin and 2 patients had incomplete data for evaluation. Of the remaining 13 patients, 69% (11) had a reduction in pain score after treatment. In addition, 2 of the patients who discontinued use had a pain score which decreased to 0. Pregabalin is a well-tolerated, effective means of treating post-burn neuropathic pain. Time to achieve effective dosing is relatively quick and there is a range of dosing available. The mechanism, pharmacokinetic benefits, and potential benefits are discussed. Further studies will be needed to look effects on quality of life and reduction of opioid use.