Anesthesia & Analgesia 2013 Jan; 116(1):211-5.
Efficacy of intrathecal baclofen on different pain qualities in complex regional pain syndrome.
van der Plas AA, van Rijn MA, Marinus J, Putter H, van Hilten JJ.
Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC
Leiden, the Netherlands. A.A.van_der_Plas@lumc.n.
BACKGROUND: Complex regional pain syndrome (CRPS) is characterized by severe
debilitating chronic pain. Patients with CRPS may experience various pain
sensations, which likely embody different pathophysiologic mechanisms. In this
study, we evaluated the differential effects of central γ-aminobutyric acid (B)
receptor stimulation on the different pain qualities in CRPS patients with
dystonia.
METHODS: The 10 pain qualities of the neuropathic pain scale, dystonia severity,
and changes in use of antinociceptive drugs were evaluated every 3 months for a
period of 1 year in 42 CRPS patients with dystonia receiving titrated doses of
intrathecal baclofen (ITB) treatment in an open design.
RESULTS: Using a linear mixed model analysis and controlling for global dystonia
severity and the use of supplemental analgesics, we found a significant
improvement in global intense pain, sharp pain, dull pain, and deep pain during
the first 6 months. After this period, the scores leveled off despite further
improvement of dystonia and continued ITB dose escalation.
CONCLUSIONS: γ-Aminobutyric acid (B) receptor stimulation by ITB exerts
differential antinociceptive effects on specific pain qualities in CRPS patients
with dystonia.
PMID: 23223108 [PubMed - in process]
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