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CRITICAL CARE AND TRAUMA

The Comparative Evaluation of Gabapentin and Carbamazepine for Pain Management in Guillain-Barré Syndrome Patients in the Intensive Care Unit

Chandra Kant Pandey, MD^*, Mehdi Raza, MD^*, Mukesh Tripathi, MD^*, Deepa V. Navkar, MD^*, Abhishek Kumar, MD^*, and Uttam K. Singh, PhD

*Departments of Anaesthesiology and Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

Address correspondence to Chandra Kant Pandey, MD, Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India. Address e-mail to ckpandey{at}sgpgi.ac.in. Reprints will not be available from the authors.

We evaluated the effects of gabapentin and carbamazepine for pain relief in 36 Guillain-Barré syndrome patients. Patients were randomly assigned to receive gabapentin 300 mg, carbamazepine 100 mg, or matching placebo 3 times a day for 7 days. Fentanyl 2 µg/kg was used as a supplementary analgesic on patient demand. The pain score was recorded by using a numeric pain rating scale of 0–10, and sedation was recorded with a Ramsay sedation scale of 1–6 before medications were given and then at 6-h intervals throughout the study period. Total daily fentanyl consumption was recorded each day for each patient. The results of the study demonstrated that patients in the gabapentin group had significantly lower (P < 0.05) median numeric pain rating scale scores (3.5, 2.5, 2.0, 2.0, 2.0, 2.0, and 2.0) compared with patients in the placebo group (6.0, 6.0, 6.0, 6.0, 6.0, 6.0, and 6.0) and the carbamazepine group (6.0, 6.0, 5.0, 4.0, 4.0, 3.5, and 3.0). There was no significant difference in fentanyl consumption between the gabapentin and carbamazepine groups on Day 1 (340.1 ± 34.3 µg and 347.5 ± 38.0 µg, respectively), but consumption was significantly less in these 2 groups compared with the placebo group (590.4 ± 35.0 µg) (P < 0.05). For the rest of the study period, there was a significant difference in fentanyl consumption among all treatment groups, and it was minimal in the gabapentin group (P < 0.05). We conclude that gabapentin is more effective than carbamazepine for decreasing pain and fentanyl consumption.

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