Clinical study of pregabalin combined with opioids in the treatment of malignant neuropathic pain

ZHOU Bin; WANG Pin; SUN Hao; JIN Yi

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 group 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, vomi-ting, dizziness, drowsiness and constipation with not statistically significant difference among 3 groups ( P>0?05) . The dosages of oxy-codone 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 signifi-cant 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.