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A Retrospective Analysis of Gabapentinoid and Opioids to Opioid Monotherapy for Pain Relief in Patients with Chronic Neck and Low Back Pain.
Pain Med. 2021 08 06; 22(8):1760-1766.PM

Abstract

OBJECTIVE

We compared the reduction in pain and opioid consumption in patients with chronic spinal pain on concomitant gabapentinoids and opioids with patients using opioids only.

DESIGN

This was a retrospective chart review of patients with chronic neck or low back pain who were on opioids with at least a 24-month follow-up.

SETTING

Single-center pain clinic in an urban setting.

SUBJECTS

167 patients with chronic spinal pain lasting at least six months.

METHODS

Patients on gabapentin or pregabalin were included in the gabapentinoid group, while the other patients were included in the non-gabapentinoid group. Primary outcome was assessment of pain scores measured via a numeric rating scale (NRS), and secondary outcomes were response to the treatment (>2 point reduction on NRS) and daily opioid use measured in morphine milliequivalents.

RESULTS

Pain scores were reduced in the first six months and plateaued after that in both groups. At the end of 24 months, the average pain score was 6.71 in the gabapentinoid group, while the average pain score was 7.18 in the non-gabapentinoid group. There was no statistical significance between the groups (p = 0.28). There was no difference in response to treatment in gabapentinoid group (33.3%) when compared with non-gabapentinoid group (32.7%). We also failed to find any significant difference in daily opioid usage between the two groups.

CONCLUSION

Gabapentinoids may not lead to reduction in pain or opioid consumption in patients with chronic spinal pain. A careful approach must be adopted while prescribing gabapentinoids in the chronic spinal pain patient population.

Authors+Show Affiliations

Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois. Department of Anesthesiology, University of Illinois, Chicago, Illinois. Department of Surgery, University of Illinois, Chicago, Illinois, USA.Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois.Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois.Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois. Department of Anesthesiology, University of Illinois, Chicago, Illinois. Department of Surgery, University of Illinois, Chicago, Illinois, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33502505

Citation

Knezevic, Nebojsa Nick, et al. "A Retrospective Analysis of Gabapentinoid and Opioids to Opioid Monotherapy for Pain Relief in Patients With Chronic Neck and Low Back Pain." Pain Medicine (Malden, Mass.), vol. 22, no. 8, 2021, pp. 1760-1766.
Knezevic NN, Aijaz T, Camacho-Ortega A, et al. A Retrospective Analysis of Gabapentinoid and Opioids to Opioid Monotherapy for Pain Relief in Patients with Chronic Neck and Low Back Pain. Pain Med. 2021;22(8):1760-1766.
Knezevic, N. N., Aijaz, T., Camacho-Ortega, A., & Candido, K. D. (2021). A Retrospective Analysis of Gabapentinoid and Opioids to Opioid Monotherapy for Pain Relief in Patients with Chronic Neck and Low Back Pain. Pain Medicine (Malden, Mass.), 22(8), 1760-1766. https://doi.org/10.1093/pm/pnab006
Knezevic NN, et al. A Retrospective Analysis of Gabapentinoid and Opioids to Opioid Monotherapy for Pain Relief in Patients With Chronic Neck and Low Back Pain. Pain Med. 2021 08 6;22(8):1760-1766. PubMed PMID: 33502505.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Retrospective Analysis of Gabapentinoid and Opioids to Opioid Monotherapy for Pain Relief in Patients with Chronic Neck and Low Back Pain. AU - Knezevic,Nebojsa Nick, AU - Aijaz,Tabish, AU - Camacho-Ortega,Alvaro, AU - Candido,Kenneth D, PY - 2021/1/28/pubmed PY - 2021/9/14/medline PY - 2021/1/27/entrez KW - Chronic Pain KW - Gabapentin KW - Gabapentinoid KW - Opioids KW - Pregabalin SP - 1760 EP - 1766 JF - Pain medicine (Malden, Mass.) JO - Pain Med VL - 22 IS - 8 N2 - OBJECTIVE: We compared the reduction in pain and opioid consumption in patients with chronic spinal pain on concomitant gabapentinoids and opioids with patients using opioids only. DESIGN: This was a retrospective chart review of patients with chronic neck or low back pain who were on opioids with at least a 24-month follow-up. SETTING: Single-center pain clinic in an urban setting. SUBJECTS: 167 patients with chronic spinal pain lasting at least six months. METHODS: Patients on gabapentin or pregabalin were included in the gabapentinoid group, while the other patients were included in the non-gabapentinoid group. Primary outcome was assessment of pain scores measured via a numeric rating scale (NRS), and secondary outcomes were response to the treatment (>2 point reduction on NRS) and daily opioid use measured in morphine milliequivalents. RESULTS: Pain scores were reduced in the first six months and plateaued after that in both groups. At the end of 24 months, the average pain score was 6.71 in the gabapentinoid group, while the average pain score was 7.18 in the non-gabapentinoid group. There was no statistical significance between the groups (p = 0.28). There was no difference in response to treatment in gabapentinoid group (33.3%) when compared with non-gabapentinoid group (32.7%). We also failed to find any significant difference in daily opioid usage between the two groups. CONCLUSION: Gabapentinoids may not lead to reduction in pain or opioid consumption in patients with chronic spinal pain. A careful approach must be adopted while prescribing gabapentinoids in the chronic spinal pain patient population. SN - 1526-4637 UR - https://www.unboundmedicine.com/medline/citation/33502505/A_Retrospective_Analysis_of_Gabapentinoid_and_Opioids_to_Opioid_Monotherapy_for_Pain_Relief_in_Patients_with_Chronic_Neck_and_Low_Back_Pain_ L2 - https://academic.oup.com/painmedicine/article-lookup/doi/10.1093/pm/pnab006 DB - PRIME DP - Unbound Medicine ER -