Efficacy of intrathecal baclofen on different pain qualities in complex regional pain syndrome.

Abstract

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.

• Authors: Anton A van der Plas, Monique A van Rijn, Johan Marinus, Hein Putter, Jacobus J van Hilten
• Journal: Anesthesia and analgesia (Anesth Analg) Vol. 116 Issue 1 Pg. 211-5 (Jan 2013) ISSN: 1526-7598 [Electronic] United States
• PMID: 23223108 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• GABA-A Receptor Agonists
• Muscle Relaxants, Central
• Baclofen

Topics

• Adult
• Baclofen (administration & dosage, therapeutic use)
• Complex Regional Pain Syndromes (drug therapy)
• Dose-Response Relationship, Drug
• Dystonia (complications)
• Female
• GABA-A Receptor Agonists (administration & dosage, therapeutic use)
• Humans
• Injections, Spinal
• Linear Models
• Longitudinal Studies
• Male
• Muscle Relaxants, Central (administration & dosage, therapeutic use)
• Outpatients
• Pain Management (methods)
• Pain Measurement (drug effects)
• Single-Blind Method