Pain, Neuropathic Clinical Trial
Official title:
Comparison of Effectiveness of Opioid Only and Pregabalin add-on for the Treatment of Neuropathic Pain in Cervical Myelopathy Patients
There is no information on the effect of pregabalin in patients with neuropathic pain in
cervical myelopathy under routine clinical practice.
The investigators will conduct this prospective, randomized trial to determine the efficacy
of pregabalin for neuropathic pain in cervical myelopathic patients in order to validate or
refute this popular practice. The primary aim of this study was to compare Leeds assessment
of neuropathic symptoms and signs scale (LANSS) scores of neuropathic pain in cervical
myelopathy patients.
Neuropathic pain is a well-recognized clinical entity. It is defined as pain caused by the
lesion or dysfunction of the peripheral or central nervous system, and it can be diagnosed by
well-established clinical criteria. Neuropathic pain is caused by lesions or dysfunction of
the nervous system and is initiated by several cellular and molecular mechanisms. Compression
of neural and neurovascular structures may result in neuropathic pain. Although a number of
therapies are available for neuropathic pain, including antidepressants, tramadol, opioids,
and different antiepileptic drugs, the results of a recent systematic review suggest that, in
view of their balance between efficacy and tolerability, pregabalin can be regarded as first
line treatments for peripheral pain with a neuropathic component.
Pregabalin is one of antiepileptic drugs (AEDs) that have been studied in the treatment of a
wide variety of disorders, such as neuropathic pain, epilepsy, spasticity, and anxiety. The
use of AEDs in the treatment of neuropathic pain is based on a number of similarities in the
pathophysiologic and biochemical mechanisms underlying neuropathic pain and epilepsy. Its use
for the treatment of several neuropathic pain syndromes is common, and it is approved by the
Food and Drug Administration (FDA) for the treatment of diabetic neuropathy, post-herpetic
neuralgia, fibromyalgia and spinal cord injury, a model of central neuropathic pain. The
off-label use of pregabalin for the various pain syndromes in general, and for neuropathic
pain in particular, is ubiquitous. However, minimal support for this practice exists in the
literature and its cost is perhaps exorbitant. There is no information on the effect of
pregabalin in patients with neuropathic pain in cervical myelopathy under routine clinical
practice.
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