Abstract:

Objective To evaluate the analgesic efficacy of pregabalin combined with opioids in the treatment of malignant neuropathic pain （MNP）.
Methods Fifty-two patients with MNP of moderate to severe pain were enrolled and initially took 72 hours morphinepatient control intravenous analgesia（PCIA）， randomly assigned into 3 groups： group A （n=17）， receiving morphinePCIA； group B （n=18）， receiving morphinePCIA plus 75mg pregabalin （per 12h）； group C （n=17）， receiving morphinePCIA plus 150mg pregabalin （per 12h）. The oxycodone was calculated and substituted for morphine 72h after morphinePCIA for continuous 4 weeks. The 24h dosage of morphine was analyzed in 3 groups. The number of break-through pain， resting visual analogue scale （VAS） and VAS at activity during PCIA period and oral administration of oxycodone were recorded in 3 groups as well as the adverse reaction. Results Compared to group A， the dosage of every 24 hour morphine in 72h of group B and in 48， 72h of group C were low （P＜0.05）. The number of break-through pain and VAS at activity of group C were lower than group A （P＜0.05）. During the period of morphinePCIA， no serious adverse reaction were observed in 3 groups， and the common adverse reactions included nausea， vomiting， dizziness， drowsiness and constipation with not statistically significant difference among 3 groups （P＞0.05）. The dosages of oxycodone were （94.06±25.38）mg and （88.21±24.46）mg in group B and C， lower than （117.67±36.39）mg in group A with significant difference （P＜0.05）. The number of breakthrough pain of group B and C at day 7， 14， 28 were lower than group A （P＜0.05）， and the VAS at activity of group B at day 14 and group C at day 7， 14 were lower than group A （P＜0.05）. Conclusion MNP may be well controlled by pregabalin plus opioid， and the dosage of pregabalin may be needed more.