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Effects of Gabapentin in Acute Inflammatory Pain in Humans
  1. Mads U. Werner, M.D., Ph.D.,
  2. Frederick M. Perkins, M.D.,
  3. Kathrine Holte, M.D.,
  4. Juri L. Pedersen, M.D., Ph.D. and
  5. Henrik Kehlet, M.D., Ph.D.
  1. From the Acute Pain Service, Departments of Anesthesiology and Surgical Gastroenterology (M.U.W., K.H., J.L.P., H.K.), Hvidovre University Hospital, Copenhagen, Denmark; and the Department of Anesthesiology, University of Rochester (F.M.P.), Rochester, New York.
  1. Reprint requests: Mads U. Werner, M.D., Ph.D., Department of Anesthesiology 532, University Hospital, DK 2650 Hvidovre, Denmark. E-mail: madswerner{at}medscape.com

Abstract

Background and Objectives The aim of the study was to examine the analgesic effects of the anticonvulsant, gabapentin, in a validated model of acute inflammatory pain.

Methods Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Gabapentin 1,200 mg or placebo was given on 2 separate study days. Three hours after drug administration, a first-degree burn injury was produced on the medial aspect of the nondominant calf (12.5 cm2, 47°C for 7 minutes). Quantitative sensory testing (QST) included pain ratings to thermal and mechanical stimuli (visual analog scale [VAS]), assessments of thermal and mechanical detection thresholds, and areas of secondary hyperalgesia. Side effects drowsiness and postural instability were assessed by subjective ratings (VAS).

Results The burn injury induced significant primary and secondary hyperalgesia (P < .0001). Gabapentin diminished the decrease in mechanical pain threshold in the burn area (P = .04) and reduced secondary hyperalgesia, but the reduction was not significant (P = .06). Heat pain thresholds, pain during the burn, and mechanical pain in the area of secondary hyperalgesia were not significantly changed by gabapentin (P < .2). Ratings of drowsiness and unsteadiness during walking were significantly higher for gabapentin than for placebo (P < .05).

Conclusions The study indicates that gabapentin has no analgesic effect in normal skin, but may reduce primary mechanical allodynia in acute inflammation following a thermal injury. These observations suggest a clinical potential of gabapentin in the treatment of postoperative pain.

  • Acute pain
  • Allodynia
  • Anticonvulsants
  • Gabapentin
  • Hyperalgesia
  • Thermal injury

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Footnotes

  • Supported by grants from Parke-Davis, Division of Warner Lambert Nordic AB, the Danish Medical Research Council (Grant No. 28809), and the John and Birthe Meyer Foundation.