Doreen Oneschuk1, M Z al-Shahri. 1. Tertiary Palliative Care Unit, Grey Nuns Community Hospital, Division of Palliative Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND: Little is known about current practice in using the anticonvulsant gabapentin in the management of cancer-related neuropathic pain. OBJECTIVES: The main objective of this study was to describe the pattern of gabapentin use as an adjuvant analgesic for cancer-related neuropathic pain in patients admitted to a tertiary palliative care unit. METHODS: A retrospective medical chart review for 150 patients admitted to a tertiary palliative care unit over a period of 10 months. Abstracted data included patient characteristics, primary diagnoses, pain scores, and the type and dose of opioids and other adjuvants used. RESULTS: Of the 147 patients with a cancer diagnosis, 45 (31%) had neuropathic pain. Of those, 22 (49%) received gabapentin. The final daily dose of gabapentin ranged from 100 mg-3,000 mg (mean: 941 mg +/- 665 mg; median: 900 mg). Gabapentin was discontinued in 10 patients (46%). Suggested adverse effects included sedation (n = 4), dizziness (n = 1), and bitter taste (n = 1). The change in pain scores was not significantly different in those who continued on gabapentin compared to those who discontinued it. CONCLUSIONS: The retrospective nature of the study and the small sample size render solid conclusions difficult to make. However, gabapentin was discontinued in approximately half the patients who received it, and often when only modest doses were used. Similar studies from other centres may improve understanding of current practices and aid in designing future clinical trials on the subject.
BACKGROUND: Little is known about current practice in using the anticonvulsant gabapentin in the management of cancer-related neuropathic pain. OBJECTIVES: The main objective of this study was to describe the pattern of gabapentin use as an adjuvant analgesic for cancer-related neuropathic pain in patients admitted to a tertiary palliative care unit. METHODS: A retrospective medical chart review for 150 patients admitted to a tertiary palliative care unit over a period of 10 months. Abstracted data included patient characteristics, primary diagnoses, pain scores, and the type and dose of opioids and other adjuvants used. RESULTS: Of the 147 patients with a cancer diagnosis, 45 (31%) had neuropathic pain. Of those, 22 (49%) received gabapentin. The final daily dose of gabapentin ranged from 100 mg-3,000 mg (mean: 941 mg +/- 665 mg; median: 900 mg). Gabapentin was discontinued in 10 patients (46%). Suggested adverse effects included sedation (n = 4), dizziness (n = 1), and bitter taste (n = 1). The change in pain scores was not significantly different in those who continued on gabapentin compared to those who discontinued it. CONCLUSIONS: The retrospective nature of the study and the small sample size render solid conclusions difficult to make. However, gabapentin was discontinued in approximately half the patients who received it, and often when only modest doses were used. Similar studies from other centres may improve understanding of current practices and aid in designing future clinical trials on the subject.