PMID- 20060939
OWN - NLM
STAT- MEDLINE
DCOM- 20100511
LR  - 20181201
IS  - 1743-9159 (Electronic)
IS  - 1743-9159 (Linking)
VI  - 8
IP  - 3
DP  - 2010
TI  - Gabapentin (Neurontin) improves pain scores of patients with critical limb 
      ischaemia: an observational study.
PG  - 212-5
LID - 10.1016/j.ijsu.2009.12.009 [doi]
AB  - OBJECTIVES: The aim of this study was to assess the role of adding gabapentin 
      (Neurontin) to the prescription of patients with opiate resistant pain as a 
      result of critical limb ischaemia (CLI). METHODS: An observational pilot study 
      was performed on 20 consecutive patients with CLI who were taking all 
      experiencing rest pain despite high dose opiate analgesia. None of the patients 
      were candidates for reconstructive surgery or angioplasty due to the anatomical 
      distribution of their vascular disease or presence of co-morbidities. Gabapentin 
      was commenced at 300 mg daily and titrated to 300 mg tds over 3 days. Doses were 
      then increased up to 600 mg tds as indicated. Pain was assessed by visual 
      analogue scoring at baseline, 4, 7, 14 and 28 days. Improvements in night pain 
      and need for opiates were also noted. The primary end point was pain score at 28 
      days or until surgical intervention/death if these points occurred sooner. 
      RESULTS: Nineteen of 20 reported significant night pain, 15 had gangrene or 
      ulceration. Seventeen of 20 patients completed the full observation period of 28 
      days. Two patients required an operation and 1 patient died of a myocardial 
      infarct. The pain scores fell from a median of 9 (inter-quartile range [IQR]) 
      (7-9) at baseline to 5 (3-6) at 28 days. Improvement in pain scores was observed 
      in 15/17 patients. Of the 17 completing the study, 16 had experienced rest pain 
      at the time of referral of which 15 had significant benefit with gabapentin. 
      CONCLUSIONS: The study has demonstrated that gabapentin is a useful adjuvant in 
      the management of CLI and leads to significant reductions in pain scores and 
      improves night pain for most patients.
CI  - Copyright 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights 
      reserved.
FAU - Morris-Stiff, Gareth
AU  - Morris-Stiff G
AD  - Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, Rhondda 
      Cynon Taf, CF37 1JL, UK. garethmorrisstiff@hotmail.com
FAU - Lewis, Michael H
AU  - Lewis MH
LA  - eng
PT  - Journal Article
DEP - 20100111
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
RN  - 0 (Amines)
RN  - 0 (Analgesics)
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Cyclohexanecarboxylic Acids)
RN  - 56-12-2 (gamma-Aminobutyric Acid)
RN  - 6CW7F3G59X (Gabapentin)
SB  - IM
MH  - Aged
MH  - Amines/*therapeutic use
MH  - Analgesics/*therapeutic use
MH  - Analgesics, Opioid/therapeutic use
MH  - Chronic Disease
MH  - Cyclohexanecarboxylic Acids/*therapeutic use
MH  - Female
MH  - Gabapentin
MH  - Humans
MH  - Ischemia/*complications
MH  - Leg/*blood supply
MH  - Male
MH  - Pain/*drug therapy
MH  - Pain Measurement
MH  - gamma-Aminobutyric Acid/*therapeutic use
EDAT- 2010/01/12 06:00
MHDA- 2010/05/12 06:00
CRDT- 2010/01/12 06:00
PHST- 2009/07/04 00:00 [received]
PHST- 2009/12/13 00:00 [revised]
PHST- 2009/12/23 00:00 [accepted]
PHST- 2010/01/12 06:00 [entrez]
PHST- 2010/01/12 06:00 [pubmed]
PHST- 2010/05/12 06:00 [medline]
AID - S1743-9191(10)00003-8 [pii]
AID - 10.1016/j.ijsu.2009.12.009 [doi]
PST - ppublish
SO  - Int J Surg. 2010;8(3):212-5. doi: 10.1016/j.ijsu.2009.12.009. Epub 2010 Jan 11.