ROLE OF GABAPENTIN AS ADJUVANT ANALGESIC WITH OPIOIDS FOR NEUROPATHIC CANCER PAIN WHEN COMBINED WITH LOWDOSE AMITRIPTYLINE IN CANCER SUBJECTS OF TRIPURA, A NORTH EASTERN STATE OF INDIA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2015, Vol 2, Issue 36
Abstract
Neuropathic cancer pain is often refractory to standard opioid therapy. The use of adjuvant analgesics for neuropathic cancer pain is largely empirical. Although gabapentin is effective in the treatment of neuropathic cancer pain, some patients experience intolerable side effects sufficient to warrant discontinuation. This study aimed to compare the efficacy and safety of gabapentin when combined with low dose amitriptyline as adjuvant analgesic to opioid for neuropathic cancer pain. METHODS: It was a double blind placebo controlled Randomized Control Trial. 80 patients were randomized in four groups and intervention was given for 14 days. Primary and secondary outcome variables were assessed on day 8 and day 15 for statistical significance by ANOVA or chi square test as applicable. Group A: Gabapentin 100 mg b.d. + Amitriptyline 10 mg b.d.; Group B: Gabapentine 100 mg b.d. + placebo of Amitriptyline; Group C: Placebo of Gabapentine + Amitriptyline 10 mg b.d.; Group D: Placebo of Gabapentine + Placebo of Amitriptyline. RESULTS: 74 subjects completed the treatment. Worst pain score, Least Pain score, Average Pain score and current pain score in Numerical Rating Scale (NRS) by Brief Pain Inventory (BPI) in last 24 hour at enrolment, after 7 and 14 days of intervention has been measured as primary outcome variable and there were no significant difference of pain score in NRS between the groups. Among the secondary end point outcome variables only daily paroxysmal pain was significantly less (P = 0.02) in Gabapentin – amitriptyline + opioid group compared to only opioid group. CONCLUSION: Although gabapentin might be regarded as a promising new adjuvant analgesic for neuropathic cancer pain, our results indicated minimal clinical benefit. So controlled trial with higher dose of gabapentin is needed to establish its efficacy.
Authors and Affiliations
Debasis Ray, Partha Sarathi Sutradhar, Gautam Majumder, Amitava Ghosh
Keywords
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- EP ID EP232933
- DOI 10.18410/jebmh/2015/781
- Views 72
- Downloads 0
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