A prospective study on the role of gabapentin in post-burn pruritus

Abstract

Gabapentin, used in the treatment of neuropathic pain, is suggested as an alternative treatment to antihistamines for post-burn itching. There is insufficient awareness about the etiopathogenesis and available treatment options for post-burn pruritus. To study the effect of gabapentin on post-burn itching, patients with post-burn pruritus not relieved with cetirizine tablet were offered gabapentin and assessed for response by the numerically graded self-report questionnaire ‘Itch Severity Scale’ for 6 months. Treatment success was determined by reduction in the itch scores, which were statistically analysed. Twenty-three patients with post-burns pruritic hypertrophic scars were studied. All patients had history of delayed burn healing (over 3 weeks). Twenty patients completed follow-up. All 20 reported a reduction in itching with gabapentin. Mean reduction in itch severity was 4.99 (statistically significant) within the first month of starting the therapy, with sustained effect seen for the duration of treatment. No serious side effects were reported. Eighty-seven per cent of patients showed good relief from itching within 1 month of starting treatment. Overall quality of life improved considerably. Gabapentin is suggested as a protocol for second-line option in post-burn pruritus. The ‘Itch Severity Scale’ is a reliable tool for pruritus measurement, including subjective parameters.