Effects of gabapentin in acute inflammatory pain in humans

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. Reg Anesth Pain Med 2001;26:322-328.