The analgesic effect of gabapentin and mexiletine after breast surgery for cancer
- PMID: 12351281
- DOI: 10.1097/00000539-200210000-00036
The analgesic effect of gabapentin and mexiletine after breast surgery for cancer
Abstract
We investigated the analgesic efficacy of mexiletine and gabapentin on acute and chronic pain associated with cancer breast surgery in 75 patients. They were randomized to receive, in a double-blinded manner, mexiletine 600 mg/d, gabapentin 1200 mg/d, or placebo for 10 days. Anesthesia was standardized, and all patients had access to routine postoperative analgesics on demand. The visual analog scale score assessed pain at rest and after movement. Three months later, all patients were interviewed to identify intensity of chronic pain and analgesic requirements. Mexiletine and gabapentin reduced codeine consumed from the second to tenth day by 50% (P = 0.029; P = 0.018 and P = 0.035 for mexiletine versus control and gabapentin versus control comparisons, respectively). Total paracetamol consumption was also reduced during the same time (P = 0.0085; P = 0.007 and P = 0.011 for the mexiletine and gabapentin groups when compared with the control, respectively). Pain at rest and after movement was reduced by both drugs on the third postoperative day. Pain after movement also was reduced by gabapentin between the second and fifth postoperative day. Three months later, the incidence of chronic pain, its intensity, and need for analgesics were not affected by either treatment. However, burning pain was more frequent in the control group (P = 0.033).
Implications: Patients undergoing breast surgery for cancer may develop chronic pain. We evaluated the effect of mexiletine and gabapentin on the acute and chronic pain after breast surgery for cancer. Both drugs reduced the postoperative analgesic requirements, and particularly, gabapentin reduced pain after movement. The overall incidence of chronic pain was unaffected except for burning pain.
Similar articles
-
Is gabapentin effective and safe in open hysterectomy? A PRISMA compliant meta-analysis of randomized controlled trials.J Clin Anesth. 2017 Sep;41:76-83. doi: 10.1016/j.jclinane.2017.07.002. Epub 2017 Jul 18. J Clin Anesth. 2017. PMID: 28802618 Review.
-
Preoperative pregabalin or gabapentin for acute and chronic postoperative pain among patients undergoing breast cancer surgery: A systematic review and meta-analysis of randomized controlled trials.J Plast Reconstr Aesthet Surg. 2017 Oct;70(10):1317-1328. doi: 10.1016/j.bjps.2017.05.054. Epub 2017 Jun 9. J Plast Reconstr Aesthet Surg. 2017. PMID: 28751024 Review.
-
Evaluation of efficacy of the perioperative administration of Venlafaxine or gabapentin on acute and chronic postmastectomy pain.Clin J Pain. 2010 Jun;26(5):381-5. doi: 10.1097/AJP.0b013e3181cb406e. Clin J Pain. 2010. PMID: 20473044 Clinical Trial.
-
A randomized study of the effects of single-dose gabapentin versus placebo on postoperative pain and morphine consumption after mastectomy.Anesthesiology. 2002 Sep;97(3):560-4. doi: 10.1097/00000542-200209000-00007. Anesthesiology. 2002. PMID: 12218520 Clinical Trial.
-
Regional block and mexiletine: the effect on pain after cancer breast surgery.Reg Anesth Pain Med. 2001 May-Jun;26(3):223-8. doi: 10.1053/rapm.2001.23205. Reg Anesth Pain Med. 2001. PMID: 11359221 Clinical Trial.
Cited by
-
Perioperative role of oral gabapentin as an analgesic in paediatric patients: A randomised controlled trial.J Anaesthesiol Clin Pharmacol. 2023 Oct-Dec;39(4):539-543. doi: 10.4103/joacp.joacp_503_21. Epub 2023 May 24. J Anaesthesiol Clin Pharmacol. 2023. PMID: 38269158 Free PMC article.
-
Pre-Emptive Opioid-Sparing Medication Protocol Decreases Pain and Length of Hospital Stay in Children Undergoing Posterior Spinal Instrumented Fusion for Scoliosis.Iowa Orthop J. 2023;43(1):111-115. Iowa Orthop J. 2023. PMID: 37383870 Free PMC article.
-
Comparison the Effects of Gabapentin and Oxazepam on Sleep Quality, Anxiety, and Pain in Unstable Angina Patients Admitted to Coronary Care Unit of Hazrat Rasool Akram Hospital.Adv Biomed Res. 2022 Jul 29;11:57. doi: 10.4103/abr.abr_154_20. eCollection 2022. Adv Biomed Res. 2022. PMID: 36124023 Free PMC article.
-
The duration of postoperative analgesic use after total knee arthroplasty and nomogram for predicting prolonged analgesic use.Front Surg. 2022 Jul 26;9:911864. doi: 10.3389/fsurg.2022.911864. eCollection 2022. Front Surg. 2022. PMID: 35959127 Free PMC article.
-
Gabapentin for acute pain in sickle cell disease: A randomized double-blinded placebo-controlled phase II clinical trial.EJHaem. 2021 May 4;2(3):327-334. doi: 10.1002/jha2.188. eCollection 2021 Aug. EJHaem. 2021. PMID: 35844692 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical